My Mother ’ s Keeper ? Children as Unexpected Sources of Social Support Among African American Women Living With HIV-AIDS (original) (raw)
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Journal of Black Studies, 2012
HIV-AIDS continues to be an escalating health problem, particularly among women. In the United States, African American women are among the leading demographic groups for HIV prevalence. African American women represent 65% of the total women living with HIV-AIDS. The typical woman with HIV-AIDS is young, in her 20s, economically challenged, and of childbearing age. Adherence to HIV therapies is critical if patients are to achieve and maintain virologic suppression. Adherence is especially significant for women, who are often the gatekeepers of care for the family. Scholars have long recognized the importance of social support for general health and well-being. This study explores unexpected sources of social support among women living with HIV-AIDS and how social support networks may affect medication adherence, health, and well-being. Young children were identified as social actors of care.
Am I My Mother's Keeper? Unexpected Sources of Social Support for Women Living with HIV/AIDS
HIV and AIDS remains a health threat for women of color, especially African American women. The statistics among African American women are alarming. African American women represent a disproportionate number 65% of the total number of women currently living with HIV/AIDS. The social needs of HIV positive individuals were recognized early in the epidemic. Social support has been known to reduce the effects of stressful life events on health. And, the relationship between social support and health has been strongly established. Twenty women ages 20 - 49 were recruited from an outpatient clinic at an urban teaching hospital. Participants were instructed to keep a reflective journal to document facilitators and barriers to HIV medication adherence for a two-week period with a minimum of ten entries. Journals entries included: medication adherence challenges, life with a chronic disease, and sources of social support. Semi-structured interviews were also conducted. Social support played...
Perceived social support and HIV/AIDS medication adherence among African American women
Qualitative health research, 2006
HIV/AIDS incidence is increasing more quickly among women than any other segment of the population. The typical woman with HIV/AIDS is young, in her late 20s, economically challenged, and of childbearing age. Adherence to HIV therapies is critical if patients are to achieve and maintain virologic suppression. The author recruited HIV/AIDS-infected African American women from an outpatient clinic to investigate the women's perceptions of social support and how it affected their medication adherence. She collected data through tape-recorded interviews using a semistructured guide and journaling over a 2-week period. Facilitators of adherence included supportive family members and having young children. Barriers to adherence included perceived stigma, feeling unloved or uncared for, relationship turbulence, and having a husband who was also HIV positive. Although participants reported being "fairly" satisfied with the quality of support they received, emotional support an...
Journal Of Black Psychology, 2003
This study examined the role of family functioning and social support in protecting HIV-positive African American women from the adverse psychological consequences associated with deterioration in their CD4 cell count. Participants were 38 African American HIV-positive women who had recently given birth. Results demonstrated that changes in CD4 cell counts were inversely predictive of psychological distress and were moderated by family functioning and social support satisfaction. Women with good family functioning were less affected by changes in their CD4 cell counts, and women with poor family functioning were more emotionally responsive to changes in CD4 cell count. Unexpectedly, women from families where conflicts tended to be clearly laid out and discussed were also more responsive to both changes in CD4 cell counts. Interventions are recommended that increase a client's social support satisfaction, foster an adaptive level of connectedness to family, and enhance the family's range of conflict resolution styles.
Young caregivers of mothers with HIV: Need for supports
Children and Youth Services Review, 2005
Data from a qualitative longitudinal study of 55 women living with HIV in one Midwestern state reveal that the young children of such women provide vital caregiving for them. The 43 mothers (of the 55 women) in the parent study have 133 living children among them, of whom nearly all were minors when their mothers were first diagnosed with HIV. At data collection, 59 of these children were still aged 18 or under. This qualitative study examines the children of seven of these women by exploring the interview narratives in which they describe caregiving tasks performed by their children. Utilizing research literature from a variety of perspectives on children and caregiving, we examine the different developmental stages of the caregiving children and the impacts of these largely invisible responsibilities on their lives. Finding a dearth of supportive resources available to the children, we speculate about interventions that could appropriately assist them emotionally, developmentally and physically. Legitimation of young caregivers' needs will require wider recognition of caregiving and its social consequences, recognition of the sparse institutional supports that currently assist these children, and creativity in mobilizing stronger informal support systems for individual children and whole families affected by HIV/AIDS.
The role of minor and adult children in the adjustment of women living with HIV
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2009
The present study examined how having children can relate to the psychological functioning of HIV-positive women, and the place and function children have in their mother's social support and social burden networks. As part of initial face-to-face interviews with 46 HIV-positive women enrolled in a longitudinal study, participants indicated their maternal status, the nature of their social support and burden (with a modified Multidimensional Social Support Inventory) and their levels of depressive symptoms (Brief Symptom Inventory). Using Analysis of Variance (ANOVA) and non-parametric analyses when statistical assumptions were not met, findings indicate that women with minor children reported fewer depressive symptoms and more confidence in regulating social support than women without children. Maternal status was not significantly related to other measures of social support. Women with minor children reported greater comfort and confidence in regulating social burden and reported experiencing less social burden than women with adult children only. Women with adult children only reported intermediate levels of depression, but high levels of received burden and low levels of comfort and confidence in regulating (lessening) this burden. Analyses of women's social networks (Fisher's Exact Test) indicated that minor children were less likely to be named regarding support than adult or other family members and were infrequently turned to for practical, emotional, or HIV-related support. Adult children were more often listed as providing various types of support than minor children, yet these relationships were also often associated with relatively higher levels of social burden.
Social Network Structure and Social Support in HIV-Positive Inner City Mothers
Janac-journal of The Association of Nurses in Aids Care, 2005
It has been documented that social support influences health outcomes of persons with chronic illnesses. The incidence of HIV and AIDS among minority women is growing at an alarming rate, but little is known about social support in this vulnerable population, and even less is known about the social network conveying that support. Guided by the convoy of social networks model, this study describes the social networks in a sample of HIV-positive, urbandwelling mothers (N ϭ 147) by stage of disease (i.e., asymptomatic, symptomatic, AIDS) and examines relationships between social network structure and social support. Hierarchical linear modeling showed that women's social networks were disproportionately populated by children, and network members of women with AIDS were significantly older than network members of HIV-positive women with or without symptoms. Profile analyses showed that women's perceptions of the quality of social support differed according to the proportion of family members populating different segments of the social network.
Boosting Social Support in Caregivers of Children with HIV/AIDS
AIDS Patient Care and STDs, 1999
Providing care for a child that is infected with human immunodeficiency virus (HIV) is challenging for the child's caregiver and affects the entire family system. Research has demonstrated that social support has the potential to buffer caregiver stress and facilitate caregiver coping. A two-group experimental study was implemented to test the effect of a social support boosting intervention on caregiver stress, coping and social support among caregivers of children with HIV/acquired immune deficiency syndrome (AIDS). The subjects in the study were caregivers of children with HIV/AIDS. The sample strata included seropositive caregivers (biological parents) and seronegative caregivers (foster parents and extended family members). The measures for the study included the Derogatis Stress Profile, The Family Crisis Oriented Personal Evaluation Scale, and the Tilden Interpersonal Relationship Inventory. These data were then analyzed descriptively and then with a repeated measure MANOVA. Initially, there were no statistically significant differences found between the control and intervention groups. However, when subject HIV status was included in the analysis, the combined dependent variables of stress, coping, and social support were significantly related to the interactions of group by HIV status over time. F values were then computed and no statistically significant differences were found for stress or coping. There were, however, significant differences in measures of social support between groups when adjusting for HIV status of caregivers. In this study, social support levels over time for seronegative caregivers were significantly different from those of seronegative caregivers in the control group. Three case studies are presented that illustrate differences between seronegative and seropositive caregivers. The case studies describe the problems identified by caregivers and the effectiveness of problem solving using the social support boosting intervention. Finally, the mobilization of social support is discussed. Contrasts between the problems of caregivers are made relative to their HIV status. The potential for the effectiveness of the social support boosting intervention is discussed within the context of the caregiver's HIV status.
Journal of Health Care for the Poor and Underserved, 2009
The change in HIV from acute to chronic disease due to the introduction of HAART in the mid-1990s increased the importance of its successful management and imposed substantial lifestyle adjustments on HIV-positive persons and their support networks. Few studies have examined the sources and types of social support and the areas of care relevant for engagement in HIV treatment among HIV-positive Latinos and African Americans. This paper reports the results of twenty-four semi-structured in-depth interviews that were conducted with HIV-positive African American and Latino women and men who have sex with men. Formal networks were found to be more critical for engagement in HIV-specific medical care; specifically, study participants relied primarily on health care providers for support in accessing and maintaining illness-specific care. In contrast, informal networks (in the form of family and friends) were crucial for other general subsistence care, such as emotional, household-related, and financial support.
A model of mother–child coping and adjustment to HIV
Social Science & Medicine, 2003
An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother's HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother's HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent-child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother-child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother-child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index=0.94; root mean square estimate of error=0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent-child relationship. r