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Randomized Controlled Trial
. 2014 Jul;28 Suppl 3(0 3):S347-57.
doi: 10.1097/QAD.0000000000000335.

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa

Irma Eloff  1 , Michelle Finestone, Jennifer D Makin, Alex Boeving-Allen, Maretha Visser, Liesel Ebersöhn, Ronél Ferreira, Kathleen J Sikkema, Margaret J Briggs-Gowan, Brian W C Forsyth
Affiliations
Randomized Controlled Trial

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa

Irma Eloff et al. AIDS. 2014 Jul.

Abstract

Objective: The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers.

Design/methods: HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers. Mothers and children were in separate groups for 14 sessions, followed by 10 interactive sessions. The primary focus was on parent-child communication and parenting. Assessments were completed by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses were used to assess change over time.

Results: Of 390 mother-child pairs, 84.6% (I: 161 and S: 169) completed at least two interviews and were included in the analyses. Children's mean age was 8.4 years and 42% of mothers had been ill in the prior 3 months. Attendance in groups was variable: only 45.7% attended more than 16 sessions. Intervention mothers reported significant improvements in children's externalizing behaviours (ß = -2.8, P = 0.002), communication (ß = 4.3, P = 0.025) and daily living skills (ß = 5.9, P = 0.024), although improvement in internalizing behaviours and socialization was not significant (P = 0.061 and 0.052, respectively). Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence.

Conclusion: This is the first study demonstrating benefits of an intervention designed to promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context and has the potential to benefit large numbers of children, if it can be widely implemented.

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Figures

Figure 1
Figure 1. Subject participation
Figure 2
Figure 2. Child outcomes for intervention and comparison conditions
See this image and copyright information in PMC

References

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