Family and Self-Care Management of HIV infected Women and Their HIV infected Children

FAMILY AND SELF-CARE MANAGEMENT OF HIV INFECTED WOMEN AND THEIR HIV INFECTED CHILDREN Carol Ann Vincent Background: The aim of this study was to test a hypothesized model (Vincent Model) based on the theoretical and empirical literature that examines maternal factors (quality of life; depression; capacity for self-care in the context of parenting; and clinical factors) and family management factors (condition management ability; family life difficulty; and condition management effort) which may affect outcomes in HIV infected children. Methods: Self-report questionnaires and chart abstraction were used to gather data for this descriptive, cross-sectional study on a sample of 67 HIV infected mothers and their HIV infected children with whom they lived and for whom they were the primary caregiver. Participants were recruited from four pediatric HIV specialty clinics in the United States. Multivariate and binary logistic regression analyses was used to test the hypothesized model. Results: The major findings in this study are 1) quality of life factors (bodily pain, general health, and vitality) and self-care were associated with the mothers' ability to manage the child's' condition; 2) quality of life factors (bodily pain and role-emotional limitations) and self-care were associated with family life difficulty; 3) quality of life factors (general health and mental health) were associated with the mothers' condition management effort; 4) maternal depression was associated with the children's' outcomes (CD4 and HIV viral load); 5) maternal HIV viral load, depression, self-care and quality of life factor (physical functioning) were associated with children's outcomes (HIV viral load). There were no significant associations between family management and child outcomes in this model; thus, family management did not mediate the relationship between maternal and child factors; and 6) mothers reported the presence of stigma in their lives. Conclusions: While further testing of the Vincent Model is needed in larger populations, the results underscore the importance of assessing both psychosocial and clinical measures in mothers and children. Finally, advocacy for the appropriate care of individuals infected with HIV as well as for the special needs of these family members is crucial.