Poster #33 - A qualitative exploration of parent stress among families affected by HIV

• In Event: Poster Session 08

Abstract

Background: Approximately 38 million people are living with HIV (WHO, 2022). Many of these people are also raising children. Parents living with HIV (PLWH) face unique challenges such as increased parenting stress and compromised parenting quality while also dealing with concurrent challenges of trauma exposure, mental and physical health concerns, and/or substance misuse. Moreover, children of PLWH are at increased risk for behavioral problems, trauma exposure, and posttraumatic stress (Li et al., 2009). Parental stress may further exacerbate negative youth outcomes, thereby contributing to an intergenerational cycle of risk. However, PLWH’s perspectives on the impact of these challenges on their adolescent children, sources of strength, and the intergenerational transmission of risk is not well understood.

Method: This study used a qualitative approach to elucidate the perspectives of PLWH on the impact of their own health and well-being on their parenting and adolescent children’s health. Data comes from a mixed methods community-engaged needs assessment study. Parents living with HIV (N=6, 67% Black/African-American, 83% female) of youth aged 10-17 participated in in-depth semi-structured interviews probing parenting, parental stress, and youth trauma, mental health, and risk behaviors. Interviews were then transcribed and coded for themes using a ground theory approach in Nvivo 12. Each interview was coded independently by two researchers, and discrepancies were reconciled via consensus coding.

Results: Several themes emerged from analysis, including youth strengths and challenges, parent challenges and impact of HIV, intergenerational effects, trauma, teen sexual behavior, and family strengths. PLWH shared that their child faced mental health concerns, family conflict, and both difficulties and strengths in emotion regulation. PLWH also shared challenges they often face such as their own mental health, substance misuse and recovery, HIV-related stigma, financial strain, and family stress. PLWH also discussed intergenerational patterns in their families by which difficulties with mental health, substance use, sexual risk, and parenting are either passed down or disrupted across generations. All PLWH discussed trauma and its impact, and strategies to promote teens’ safety and well-being. Family strengths included parents’ resilience in coping with HIV, religion/spirituality, parents’ work-related strengths, and having adequate social support.

Discussion: Findings demonstrate that PLWH encounter a variety of challenges that impact their parenting practices and affect youth outcomes. Results underscore the perceived impact of PLWH’s co-occurring mental health, trauma, and substance misuse on their well-being and parenting practices, and highlight intergenerational patterns that either replicate or disrupt risk. Families affected by HIV also draw on several internal and external strengths. Limitations of our study include a lack of youth perspective and small sample size. Future work should continue to explore the impact of parent strengths and challenges, particularly the role of co-occurring trauma/mental health, substance use, and HIV, on youth outcomes among families affected by HIV. Findings highlight the need to target parental stress and well-being, along with positive parenting strategies, in preventions and interventions to promote positive outcomes for HIV-affected youth and families.

Authors

• Julie K Nguyen, University of South Carolina
  Presenting Author

• Nada Mussad Goodrum, University of South Carolina

• Angela D Moreland

• Aaron O'Brien, Ryan White Wellness Center, Roper St. Francis Healthcare