201120 Risk and protective factors for internalizing and externalizing behaviors among HIV-affected youth in central Haiti

Tuesday, November 10, 2009: 1:00 PM

Michelle S. Li, BHSc , Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
Joia Mukherjee, MD, MPH , Partners In Health, Boston, MA
Eddy Eustache, MA , Zanmi Lasante, Cange, Haiti
Cate Oswald, MPH , Partners In Health, Boston, MA
Pamela Surkan, ScD , International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ermaze Louis, MSW , Zanmi Lasante, Cange, Haiti
Fiona Scanlan, MA , Partners In Health, Boston, MA
Richard Wong, BS , Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
Mary C. Smith Fawzi , Department of Social Medicine / Program in Infectious Disease and Social Change, Harvard Medical School, Boston, MA
Background: In high HIV burden settings such as Haiti, youth affected by HIV/AIDS must cope with a multitude of stressors. HIV-affected youth have been shown to have an increased risk of depression and problem behaviors, which may lead to engagement in HIV risk behaviors.

Objectives: The aims of our study were: to estimate the prevalence of internalizing and externalizing behaviors in central Haiti; and to examine the associations between social, economic, and health characteristics of their caregivers with internalizing and externalizing behavior outcomes in HIV-affected youth.

Methods: Baseline data for 492 HIV-affected youth (ages 10-17) and their caregivers were collected for a feasibility study implementing a psychosocial intervention. Internalizing and externalizing behaviors were assessed using the emotional symptoms and conduct problems scales of Goodman's Strengths and Difficulties questionnaire.

Results: The majority of youth displayed internalizing (94.7%) and externalizing (65.3%) behaviors. High levels of internalizing and externalizing behaviors were associated with food insecurity (OR=1.4 and OR=1.9 respectively, p<0.05). Internalizing behaviors were also significantly associated with depressive symptoms among caregivers (OR=1.6, p=0.01) and living without a parent (OR=2.1, p=0.01). Support from friends and relatives had a significant protective effect on both internalizing (OR=0.6, p<0.05) and externalizing (OR=0.40, p<0.0001) behaviors.

Conclusions: Youth affected by HIV/AIDS have significant levels of psychological distress, particularly reporting high rates of internalizing behaviors. Psychosocial interventions should address economic insecurity and mental health of caregivers, and emphasize building strong support networks in order to decrease the psychological effects of HIV and prevent further risk taking behavior in youth.

Learning Objectives:
Describe the psychosocial impact of HIV and other stressors such as poverty among HIV-affected youth in Haiti Demonstrate how social context and families can influence the mental health of HIV-affected youth Identify priority issues that should be incorporated into psychosocial interventions for HIV-affected youth.

Keywords: HIV/AIDS, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the analysis of results and wrote the abstract content.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: International Mental Health
See more of: Mental Health