Patricia M. Simon

The Family Health Project: psychosocial adjustment of children whose mothers are HIV infected.

: The psychosocial adjustment of 87 inner-city African American children 6-11 years old whose mothers were HIV infected was compared with that of 149 children from a similar sociodemographic background whose mothers did not report being HIV infected. Children were not identified as being HIV infected. Mother reports, child reports, and standardized reading achievement scores were used to assess 4 domains of adjustment: externalizing problems, internalizing problems, cognitive competence, and prosocial competence. The results indicated that, on average, children from both groups had elevated levels of behavior problem scores and low reading achievement scores when compared with national averages. Relative to children whose mothers were not infected, those whose mothers were HIV infected were reported to have more difficulties in all domains of psychosocial adjustment. Potential family processes that may explain the findings are discussed.

The impact of maternal HIV infection on parenting in inner-city African American families.

Parenting behavior and its association with child psychosocial adjustment were examined in inner-city African American families. Participants included 86 HIV-infected women and their noninfected children and 148 HIV-seronegative women and their noninfected children. Interview data were collected concerning maternal physical health, parenting behaviors, and child psychosocial adjustment. The results indicated that mother-child relationship quality and monitoring were important parenting factors for adaptive child psychosocial functioning. HIV-infected mothers reported poorer mother-child relationship quality and less monitoring of their childrens activities than did noninfected mothers, suggesting that maternal HIV infection may disrupt effective parenting. Directions for future research and clinical implications are discussed.

Issues of Recruitment, Retention, and Compliance in Community-Based Clinical Trials With Traditionally Underserved Populations

Site-specific sociodemographic recruitment, retention, and compliance (RRC) data were solicited at two points in time from the 18 National Institutes of Health-funded Community Programs for Clinical Research on AIDS (CPCRA). Based on their experiences delivering primary care to human immunodeficiency virus-infected individuals, nurses at each site identified organizational and client-centered factors functioning as barriers to protocol participation. In addition, the clinicians described the nature, frequency, and relative success of strategies used to enhance recruitment, retention, and protocol compliance. CPCRA units where nurses had clearly identified RRC barriers related to protocol design also were the sites that had accrued the most research participants. This study suggests that as the CPCRA units evolve, the most successful programs will be those in which the clinical and research staff can identify and develop innovative strategies that will successfully overcome RRC barriers.

Women who are HIV infected: The role of religious activity in psychosocial adjustment

The role of religious activity in the psychosocial adjustment of 205 inner-city African-American women, one-half of whom are HIV infected, was examined. Those who were HIV infected reported praying more but viewed prayer as less effective in coping with a chronic illness. Frequency of prayer predicted optimism about the future, whereas religious activity was not related to current depressive symptoms.

A biopsychosocial examination of symptomatic and asymptomatic HIV-infected patients.

This study evaluated twenty-nine symptomatic and asymptomatic HIV-infected homosexual/bisexual men between eighteen and forty-five in the areas of psychiatric/psychosocial, neuropsychological, family, and immunological functioning. The subjects were referred by physicians, nurses, and mental health professionals from the Tulane/Louisiana State University AIDS Clinical Trials Unit and the C-100 outpatient Primary Care Clinic for HIV-infected patients served within the Charity Hospital of Louisiana at New Orleans. All subjects and their significant others were evaluated between November 1987 and October 1988 at the C-100 Clinic. The outcome measures were mood disturbance, psychological distress, and CD4 cell count. The most significant other family member, as selected by each subject, completed family measures. The subjects experienced psychological distress and neuropsychological problems. Active-behavioral coping appeared adaptive (related to enhanced mood) as did perceived social support (related to positive mood and lower psychological distress). Higher levels of neuropsychological functioning (verbal memory, visual memory, motor speed, and visual-motor sequencing) were associated with enhanced psychosocial functioning and/or immunological status. The findings from this study highlight the importance of conducting longitudinal studies using a multidimensional approach in which HIV-infected persons and their most significant other family members are evaluated within a biopsychosocial model.

Lifestyle factors among female prisoners with histories of psychiatric treatment

Abstract This study compared the childhood and adult living contexts, patterns of alcohol and drug use, and criminal involvement of women prisoners with histories of mental health treatment in the free community to those who have not accessed such services. A random sample of 500 women prisoners was interviewed during the intake and admission process. Respondents who have used mental services were typically older White women, undereducated, unemployed, and had children. Subjects who used mental health services were more likely to have histories of alcohol, marijuana, cocaine, and heroin abuse. Women who have used mental services were more likely to have been incarcerated for nonviolent offenses. As more female offenders enter prison with various mental health needs, prison organizations will be called on to improve their techniques for identifying women who have had prior contacts with mental health services.

HIV Infection in Inner-City African American Women: The Role of Optimism in Predicting Depressive Symptomatology

This study examined the role of optimism in longitudinally predicting depressive symptomatology. Participants were 160 inner-city African American women, 96 who reported no history of HIV infection and 64 who reported current HIV infection. HIV-infected women, relative to the women without a history of HIV infection, were less optimistic and had higher levels of depressive symptomatology based on both self-report and interviewer rating. Consistent with the proposed hypothesis, a curvilinear relationship emerged between optimism at Time 1 and depressive symptomatology at Time 2 in both samples. However, the shape of the curve differed substantially for the two samples. As predicted, therewas a U-shaped curve for the noninfected women; however, for the HIV-infected women the curve had an inverted U-shape. We discuss these findings in lightof previous conceptualizations of optimism and psychological functioning, the contextual environment in which the participating women live, unique contributions of HIV to the optimism–depressive symptomatology, and the implicationsfor infected women.