HIV-positive mothers' health status: Impact on their children's mental health

Background: The current study assessed the efficacy of the Parents and children Coping Together (PACT) model (Murphy et al., 2006), which was designed to predict maternal HIV effects on child/adolescent outcomes. Data from two longitudinal studies applying PACT model measures were utilized, encompassing a 7-year assessment time-span for HIV-infected mothers and their early/middle adolescents.

Methods: Mothers living with HIV/AIDS in Los Angeles County and their well child (age 10 - 17 years) were interviewed (English or Spanish) at 6-month intervals (N = 81 families), and medical charts were reviewed. Both maternal and child-based measures were evaluated, and a sequential longitudinal design was adopted. Child/adolescent outcomes included self-concept and depression. Maternal predictors included HIV-disclosure, CD4 count, race/ethnicity, family cohesion, and mothers' physical functioning. Model evaluation was performed using EQS with FIML.

Results: The PACT model was found to be viable in predicting child/adolescent outcomes of self-concept and depression. Model statistics showed good fit (Yuan-Bentler Scaled χ² = 184.86 [df = 76], CFI = .98, IFI = .98, NNFI = .98, RMSEA = .059). Model-based bootstrap verified these findings. Higher CD4 count (through physical functioning and child self-concept) and physical functioning (through child self-concept) were indirectly associated with lower child depression. Higher family cohesion was indirectly associated with higher child depression.

Conclusions: Effects of maternal factors on child's self-concept and depression need to be taken into consideration when developing interventions for families affected by parental HIV/AIDS, and there needs to be a reconsideration of the effects of family cohesion on child/adolescent outcomes.