TY - JOUR
T1 - Enhancing the Emotional Well-Being of Perinatally HIV-Infected Youth Across Global Contexts
AU - Small, Latoya
AU - Mercado, Micaela
AU - Gopalan, Priya
AU - Pardo, Gisselle
AU - Mellins, Claude Ann
AU - McKay, Mary Mc Kernan
N1 - Funding Information: Acknowledgments We gratefully acknowledge the grant support from the National Institutes of Health [R03 DA024572-PI: McKay (CHAMP+ Argentina), R21 NR010474-PI: Mellins (CHAMP+ SA), R34 MHO72382-PI: McKay (CHAMP+ US), and R01 HD074052-PI: McKay (VUKA Family Program: Supporting Perinatally HIV+ Youth in South Africa)]. In addition, we wish to thank participating families and research staff, including our collaborators at the Human Sciences Research Council (Bhana), University of KwaZulu-Natal (Petersen), Harlem Hospital (Abrams), and Hospitale de Garrahan (Bologna, Borgata). Publisher Copyright: © 2014, Springer International Publishing.
PY - 2014/3/1
Y1 - 2014/3/1
N2 - Introduction: Increased access to antiretroviral treatment worldwide makes it more possible for children diagnosed with HIV before their 15th birthday to age into adolescence and beyond. Many HIV+ youth navigate stressors including poverty and resource scarcity, which may converge to produce emotional distress. For over a decade, Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP) investigators partnered with youth, caregivers, providers, and community stakeholders to address the health, mental health, and risk-taking behaviors of perinatally HIV-infected youth. This paper explores the mental health needs of aging cohorts of HIV+ youth, across three global contexts, New York (USA), Buenos Aires (Argentina), and KwaZulu-Natal (South Africa), to inform the development and implementation of a combination of HIV care and prevention supports for HIV+ youth. Methods: Analysis of data pooled across three countries involving HIV+ early adolescents and their caregivers over time (baseline and 3-month follow-up) was conducted. Univariate and multivariate analyses were applied to data from standardized measures used across sites to identify mental health needs of youth participants. The impact of the site-specific versions of a family-strengthening intervention, CHAMP+ US, CHAMP+ Argentina, CHAMP+ SA, was also examined relative to a randomized standard of care (SOC) comparison condition. Results: Analyses revealed mental health resilience in a large proportion of HIV+ youth, particularly behavioral functioning and overall mental health. Yet, significant numbers of caregivers across country contexts reported impaired child emotional and prosocial well-being. Significant site differences emerged at baseline. Involvement in the CHAMP+ Family Program was related to significant improvement in emotional well-being and a trend towards enhanced prosocial behavior relative to SOC across global sites. Conclusions: Ongoing partnerships with youth, family, and provider stakeholders across global sites helped to tailor programs like CHAMP+ to specific contextual needs. This has global intervention research and care implications as cohorts of HIV+ children age into adolescence.
AB - Introduction: Increased access to antiretroviral treatment worldwide makes it more possible for children diagnosed with HIV before their 15th birthday to age into adolescence and beyond. Many HIV+ youth navigate stressors including poverty and resource scarcity, which may converge to produce emotional distress. For over a decade, Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP) investigators partnered with youth, caregivers, providers, and community stakeholders to address the health, mental health, and risk-taking behaviors of perinatally HIV-infected youth. This paper explores the mental health needs of aging cohorts of HIV+ youth, across three global contexts, New York (USA), Buenos Aires (Argentina), and KwaZulu-Natal (South Africa), to inform the development and implementation of a combination of HIV care and prevention supports for HIV+ youth. Methods: Analysis of data pooled across three countries involving HIV+ early adolescents and their caregivers over time (baseline and 3-month follow-up) was conducted. Univariate and multivariate analyses were applied to data from standardized measures used across sites to identify mental health needs of youth participants. The impact of the site-specific versions of a family-strengthening intervention, CHAMP+ US, CHAMP+ Argentina, CHAMP+ SA, was also examined relative to a randomized standard of care (SOC) comparison condition. Results: Analyses revealed mental health resilience in a large proportion of HIV+ youth, particularly behavioral functioning and overall mental health. Yet, significant numbers of caregivers across country contexts reported impaired child emotional and prosocial well-being. Significant site differences emerged at baseline. Involvement in the CHAMP+ Family Program was related to significant improvement in emotional well-being and a trend towards enhanced prosocial behavior relative to SOC across global sites. Conclusions: Ongoing partnerships with youth, family, and provider stakeholders across global sites helped to tailor programs like CHAMP+ to specific contextual needs. This has global intervention research and care implications as cohorts of HIV+ children age into adolescence.
KW - ART
KW - Adolescents
KW - Antiretroviral treatment
KW - Argentina
KW - Behavioral health
KW - HIV
KW - Mental health
KW - Perinatally infected HIV youth
KW - South Africa
KW - United States
KW - Well-being
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U2 - 10.1007/s40609-014-0009-6
DO - 10.1007/s40609-014-0009-6
M3 - Article
SN - 2196-8799
VL - 1
SP - 25
EP - 35
JO - Global Social Welfare
JF - Global Social Welfare
IS - 1
ER -