“I Should Learn from Her”: Shared Resilience among Black & Latina Mothers Living with HIV and their Children

• In Event: Resilience and Protection in Black and Latinx Families

Abstract

Background: The U.S. HIV epidemic disproportionately impacts Black/African American and Latina women (CDC, 2020). Discrimination related to their race/ethnicity and gender is further compounded by HIV stigma. Additionally, many women living with HIV are primary caregivers for children and must navigate the unique stresses of parenting while managing a chronic illness. Despite the adversity they face, many mothers living with HIV (MLH) and their children are resilient, which is much less documented. This qualitative study explored factors promoting well-being in these families and parent-child relationship-based resilience. Though much research focuses on challenges facing this population, a strengths-based approach may highlight important avenues for prevention and intervention.

Method: The sample included 14 MLH and 13 children (n=27). Participants completed qualitative interviews after participating in a larger randomized controlled trial of an HIV disclosure intervention and following mothers’ disclosure of their HIV status to their children. Children’s average age was 12.50 (SD=1.91, range 9-16), and half (n=7) were girls. Half (50.0%) of the sample identified as Latinx/Hispanic, 42.9% identified as non-Hispanic Black/African American, and 7.1% were multiracial. Interviews were conducted with mothers and children, individually, in English or Spanish. Given the focus of the larger study, interview questions centered on HIV disclosure, parenting, and child functioning. Resilience, the focus of this study, was not explicitly probed but was discussed organically by all families. Interviews were transcribed and coded by a team using directed content analysis (Hsieh & Shannon, 2005).

Results: Four broad themes and several subthemes emerged, including individual resilience of each the child and parent, shared resilience within the dyad, and external sources of resilience. MLH and children discussed internal characteristics of the child, such as autonomy, goal-directedness, and positive outlook, as factors supporting child resilience. MLH described their own resilience in coping with HIV, dealing with past trauma and mental health concerns, and substance abuse recovery. Within the parent-child dyad, factors promoting resilience included open communication, affection, security, and mothers’ modeling of positive coping skills. Notably, participants often cited the general stability and/or improvement in the relationship and child’s well-being as evidence of thriving after HIV disclosure. External sources of resilience most frequently discussed were social and family support, religion/spirituality, and HIV-related or community resources.

Discussion: Results revealed several demonstrations of resilience in HIV-affected families. Given these descriptions of resilience, it is crucial to understand the cultural nuance associated with adaptation in the face of adversity, including HIV, which is an ongoing adversity, and interrogate whose measure of success following adversity families from marginalized communities must measure up to. For example, parents and children highlighted that children’s emotional and behavioral stability following disclosure helped parents feel more comfortable closing the relationship gap that may have been present prior to disclosure. The stability may indicate “thriving” while managing this chronic and intergenerational stressor, leading to global relationship improvements. Overall, Black and Latinx MLH and their children offered insight into the cultivation of both individual and shared experiences of resilience, highlighting potential targets for strengths-based family interventions that further bolster these processes.

Authors

• Jamee S Carroll, University of Maryland School of Medicine
  Presenting Author

• Nada Mussad Goodrum, University of South Carolina