201121 Psychosocial functioning among HIV-affected youth and their parents/ caregivers in Haiti—implications for public health programs in high HIV burden settings

Tuesday, November 10, 2009: 1:15 PM

Mary C. Smith Fawzi, ScD , Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
Eddy Eustache, MA , Zanmi Lasante, Cange, Haiti
Cate Oswald, MPH , Partners In Health, Boston, MA
Pamela Surkan, ScD , Department of Social and Behavioral Interventions, 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
Michelle Li, BS , Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
Lucinda Leung, AB , Harvard School of Public Health, Boston, MA
Joia Mukherjee, MD, MPH , Partners In Health, Boston, MA
Objectives: The aims of the study were to: 1) describe the burden of psychiatric symptoms and degree of psychosocial functioning among HIV-affected youth and their parents/caregivers in central Haiti; and 2) examine the association between depressive symptoms in parents/caregivers and psychosocial outcomes among HIV-affected youth.

Methods: Baseline data from a study examining the feasibility of a psychosocial intervention for HIV-affected youth and their parents/caregivers were analyzed. For 492 participating youth, 330 caregivers participated since some families had more than one child enrolled. HIV-affected youth were recruited from Zanmi Lasante's catchment area in central Haiti. Inclusion criteria were: ages 10-17; had HIV-positive caregiver or parent had died from HIV; or youth was HIV-positive.

Results: HIV-affected youth demonstrated very high levels of anxiety, the most common symptoms reported were constant fidgeting (86%), headaches/stomachaches (84%), and restlessness (83%). Among their parents/caregivers, who were 89% HIV-positive, the most common depressive symptoms were feeling: low in energy (73%), everything is an effort (71%) and sadness (69%). Parents' level of depressive symptoms was associated with their children's overall symptom levels (OR=2.4; 95%CI:1.6-3.6) and their psychosocial functioning (OR=1.6; 95%CI:0.96-2.6) after controlling for confounding factors.

Conclusions: Public health interventions (e.g. HIV-prevention activities) targeting HIV-affected orphans and vulnerable children (OVC) should address their mental health status as well as their parents' level of depression. A family-focused approach integrating health/mental health services for HIV-affected youth may be beneficial for both the youth and their parents, particularly those who are HIV-positive and require adherence to daily antiretroviral regimens.

Learning Objectives:
1) Describe the level of psychosocial functioning and psychiatric symptoms among HIV-affected youth in central Haiti. 2) Assess level of depressive symptoms among parents/ caregivers of HIV-affected youth and examine the association with psychiatric symptoms and psychosocial functioning in their children. 3) Discuss potential strategies for service provision for HIV-affected families, including consideration of a family-focused approach, and an integrated health/mental health program, particularly for promoting adherence among HIV-positive parents and children and prevention among HIV-affected youth.

Keywords: HIV/AIDS, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Co-Principal Investigator of the project and I have conceptualized the research questions and drafted the abstract.
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.

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See more of: Mental Health