Jamie N. Albright

‘Someone Needs to Carry on the Legacy of My Family’: Childbearing Perceptions Among Adolescents and Young Adults with Perinatally Acquired Hiv

ABSTRACT Objectives: This qualitative project explored perceptions of adolescents and young adults (AYA) with perinatally acquired HIV (PHIV) regarding childbearing motivations and parenting. Methods: In-depth interviews were conducted with 35 AYA with PHIV (Mage = 20.5 years). Results: Primary childbearing motivations included the desire to experience parenthood, a wish to leave a legacy, and the chance to offer/receive unconditional love. Anticipated challenges included normative concerns (e.g., cost of parenting) and such HIV-specific concerns as parental disclosure/risk for transmission. Conclusions: Information is needed to tailor developmentally and culturally sensitive interventions to promote healthy development across the life span among the 3rd generation of HIV-affected families.

Appraisal Support from Natural Mentors, Self-worth, and Psychological Distress: Examining the Experiences of Underrepresented Students Transitioning Through College

The current study explored whether cumulative appraisal support from as many as five natural mentors (i.e., nonparental adults from youth’s pre-existing social networks who serve a mentoring role in youth’s lives) led to reduced symptoms of depression and anxiety via improved global self-worth among underrepresented college students. Participants in the current study included 340 college students (69% female) attending a 4-year, predominantly White institution of higher education. Participants were first-generation college students, students from economically disadvantaged backgrounds, and/or students from underrepresented racial/ethnic minority groups. Participants completed surveys during the Fall and Spring of their first year of college and in the Spring of their second and third years of college. Results of the structural equation model (including gender, race/ethnicity, and extraversion as covariates) indicated that greater total appraisal support from natural mentoring relationships predicted decreases in students’ psychological distress via increases in self-worth (indirect effects assessed via boot-strapped confidence intervals; 95% CI). The strength of association between appraisal support and self-worth was not moderated by the proportion of academic natural mentors. Findings from the current study extend previous research by measuring multiple natural mentoring relationships and pinpointing supportive exchanges that may be of particular consequence for the promotion of healthy youth development. Institutional efforts to reinforce pre-existing natural mentoring relationships and encourage the onset of new natural mentoring relationships may serve to bolster the well-being and success of underrepresented students attending predominantly White universities.

Applying a Social Justice Lens to Youth Mentoring: A Review of the Literature and Recommendations for Practice

Youth mentoring interventions are often designed with the intention of promoting improved outcomes among marginalized youth. Despite their promise to reduce inequality through the provision of novel opportunities and increased social capital to marginalized youth, youth mentoring interventions hold the potential to reproduce rather than reduce inequality. In the current review, we explore literature on youth mentoring that has incorporated a social justice lens. We conclude that there is a need for greater attention to principles of social justice in the design, implementation, and evaluation of youth mentoring interventions. After reviewing the literature, we make recommendations for research and practice based on a social justice perspective and explore alternatives to traditional youth mentoring that may allow for better alignment with social justice principles.

“I Definitely Want Kids, But I Think the Risks Are Pretty High”: Fertility Desires and Perinatal HIV Transmission Knowledge Among Adolescents and Young Adults with Perinatally-Acquired HIV

Today youth with perinatally-acquired HIV (PHIV) are living into young adulthood. Relatively little is known about their reproductive intentions or knowledge of ways to prevent perinatal HIV transmission (PHT). Interviews were conducted with 35 adolescents and young adults (AYA) (mean age 20.7 years) with PHIV recruited from two pediatric infectious disease clinics in the southeast U.S. The majority of participants were African American (n = 27, 77.1 %) and female (n = 23, 65.7 %). This cross-sectional study examined fertility desires and intentions of the maturing population of individuals with perinatally-acquired HIV (PHIV) and their knowledge of PHT. Twenty-three percent (n = 8) of participants had ever experienced a pregnancy and 14.3 % (n = 5) were current parents or pregnant. Among participants, 88.6 % (n = 31) expressed a desire to have a child in the future among whom 93.5 % (n = 29) intend to have a child. Only eight participants accurately reported the risk of PHT. The mean reported risk of PHT was 32.5 %. Age and history of pregnancy were not related to knowledge. Despite errors in estimating risk, many participants knew important information about factors that could reduce the risk of PHT including “take medicine”, “be healthy”, have a C-section, avoid breastfeeding, and maintain a low viral load. Case studies highlight the complex factors that may explain high levels of fertility desires and intentions yet low levels of PHT prevention, while also providing insight into areas for intervention. Reproductive and sexual health education must include discussion of fertility desires and intentions rather than simply focusing on pregnancy and transmission prevention as a means to heighten the effectiveness of harm reduction strategies and support the health functioning of the maturing population of youth with PHIV as they enter adulthood.

Constellations of social support among underrepresented college students: Associations with mental health

ABSTRACT Students from underrepresented groups are increasingly enrolling in 4-year institutions, yet they may face additional stressors upon entering college compared to majority peers. Supportive relationships with peers, parents, and natural mentors may foster successful adjustment to college among such students. The current study examined patterns of social support among 340 underrepresented first-year students at an elite, predominantly White, public university. Latent profile analysis was used to characterize support networks. Four profiles of support emerged: Average Frequency Support (AFS), Higher Frequency Support (HFS), Lower Frequency Support (LFS), and Compensatory Mentor Support (CMS). Participants in the HFS profile started college with the highest levels of psychological distress and also demonstrated the greatest improvements in mental health. Results suggest that the most vulnerable students may require greater support to have a psychologically healthy transition to college.

Natural Mentors, Racial Pride, and Academic Engagement Among Black Adolescents Resilience in the Context of Perceived Discrimination

The current study examined the potential of relational closeness in the natural mentoring relationships (NMRs) of Black students to counter and protect against the noxious effects of school-based discrimination on academic engagement. The study sample included 663 Black students between the ages of 12 and 19 (M = 14.96 years, SD = 1.81 years), all reporting a natural mentor. Approximately half of participants were female (53%). Participants were recruited from three different school districts in a Midwestern metropolitan area. Findings indicated that perceived school-based discrimination was negatively associated with academic engagement. Relational closeness in NMRs countered, but did not protect against, the negative effects of perceived school-based discrimination on students’ academic engagement. Additional analyses indicated that one mechanism through which relational closeness in NMRs may promote greater academic engagement among Black students is via increased racial pride. Results highlight the potential of NMRs to counter messages of inferiority communicated through discriminatory experiences in the school. Fostering relational closeness between Black students and supportive non-parental adults in their lives may be an effective strategy to boost academic achievement among Black youth experiencing discrimination in the school environment. In addition to fostering stronger bonds with natural mentors, strategic efforts to reduce school-based discrimination are needed to truly bolster the academic success of Black youth.

Self-reported sexual and reproductive health information/services received by adolescents and young adults with perinatally acquired HIV: what are their needs?

ABSTRACT Adolescents and young adults (AYA) living with perinatally acquired HIV (PHIV) are now living well into young adulthood due to medical advances in the treatment and management of HIV. Research indicates that AYA with PHIV engage in developmentally expected sexual behaviors yet little is known about the type of sexual and reproductive health (SRH) information/services this cohort receives from HIV health care providers. Thirty-five AYA with PHIV engaged or formerly engaged in care at two pediatric infectious disease clinics in the southeastern United States were interviewed to assess the SRH information/services received from providers. Mean age of participants was 20.7 years (range 15–30). Most were African American (n = 27, 77.1%) and female (n = 23, 69.7%). The majority of participants were sexually active (71.4%) and used contraceptives (64.0%). The most frequently discussed SRH topics included sexually transmitted disease (STD) prevention (75.8%), condom use (72.7%) and information about STDs (72.7%). Discussions with providers about sexual risk reduction topics occurred more frequently than psychosocial aspects of SRH such as including romantic partners in medical appointments (33.3%), sexual violence (35.3%) and romantic relationships in general (45.2%). While most participants (88.6%) reported a desire to have children, only half reported childbearing discussions with HIV health care providers. Females reported receiving more SRH information/services than males, but the difference was not statistically significant. Providers initiated the overwhelming majority of SRH-related conversations. Participants expressed a preference to talk about SRH topics with members of their HIV care teams, rather than with non-clinic providers. Overall, these findings indicate the need for improved and increased SRH information/services offered to the maturing population of AYA living with PHIV within HIV care settings.

“Now I Know I Love Me”: The Trajectory to Self-Acceptance Among HIV Positive Adults in a Southeastern U.S. Community Center

Individuals with HIV are now living healthier, longer lives due to the advancement of effective drug therapy. Understanding the dynamic narratives of the aging population of adults with HIV is critical in amplifying the voice of those who are often marginalized and to inform those social and medical providers with whom they most frequently engage. This article describes the narratives of 18 adults between the ages of 38 and 60 years diagnosed with HIV who frequent a community-based center in the southeastern United States. Recorded semi-structured interviews focused on how participants’ lives had changed since diagnosis with HIV. Transcribed interviews analyzed for emergent themes. Analysis of participant narratives revealed a cohesive trajectory from self-condemnation toward self-acceptance including acquisition of HIV and judgment of past behaviors, aftermath of the diagnosis, cultivating hope, and self-acceptance. Findings offer a window into the experiences of multiply marginalized adults living with HIV in the southern United States. Examining illness narratives in the context of their unique experience within an exclusively HIV-positive support center may offer valuable information for medical and social service providers as they develop strategies to support the aging population of adults living with HIV.

Attachment, Appraisal Support, and the Transition to College Among Underrepresented Students

This study investigated associations among attachment to caregivers, peer appraisal support, and depressive symptoms during the transition to college among underrepresented college students attending an elite predominantly White institution (PWI). It was hypothesized that more secure attachment to caregivers would be related to reductions in the experience of depressive symptoms during the transition to college both directly and indirectly through peer appraisal support. Participants in this longitudinal study included 340 first-year undergraduate students attending a selective PWI. The results of this study show that secure attachment to caregivers was related to fewer depressive symptoms during the first semester of college and indirectly related to reductions in depressive symptoms from the first to the second semester through increased peer appraisal support. The results of this study suggest an enduring role of attachment to caregivers in underrepresented students’ mental health during this challenging life transition.

Psychosocial Considerations for Children and Adolescents with HIV

The purpose of this chapter is to describe psychosocial factors that influence the mental health and well-being of children and adolescents living with HIV. Research focused on the variable rates of psychological symptomatology, and substance use will be described along with an examination of contextual factors that can ameliorate or exacerbate psychological distress. Information about evidence-based interventions designed to support mental health are described, along with the challenges and opportunities presented by the transition to adulthood.