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The Journal of the American Board of Family Practice 18:362-373 (2005)
© 2005 American Board of Family Practice

Original Research

Psychological Distress, Substance Use, and Adjustment among Parents Living with HIV

Risë B. Goldstein, PhD, MPH, Mallory O. Johnson, PhD, Mary Jane Rotheram-Borus, PhD, Sheri B. Kirshenbaum, PhD, Rogério M. Pinto, PhD, LMSW, Lauren Kittel, PsyD, Willo Pequegnat, PhD, Joanne D. Mickalian, MA, Lance S. Weinhardt, PhD, Jeffrey A. Kelly, PhD, Marguerita Lightfoot, PhD the National Institute Mental Health Healthy Living Project Team

Center for Community Health, UCLA Neuropsychiatric Institute (RBG, MJR-B, ML)
Center for AIDS Prevention Studies, University of California-San Francisco, San Francisco, CA (MOJ, JDM)
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY (SBK, RMP, LK)
National Institute of Mental Health, Bethesda, MD (WP)
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI (LSW, JAK)

Correspondence: Corresponding author: Risë B. Goldstein, PhD, MPH, Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3068, MS 9304, Bethesda, MD 20892-9304 (e-mail goldster{at}mail.nih.gov)

Background: Being a parent, especially a custodial parent, living with HIV was anticipated to increase psychological distress and challenges to self-care.

Methods: Mental health symptoms, substance use, and health care utilization were assessed among 3818 HIV-infected adults, including custodial parents, noncustodial parents, and nonparents, in 4 AIDS epicenters.

Results: Custodial parents demonstrated significantly poorer medication adherence and attendance at medical appointments but were similar to nonparents and noncustodial parents in mental health symptoms and treatment utilization for mental health and substance use problems. Noncustodial parents demonstrated the highest levels of recent substance use and substance abuse treatment. Other markers of risk, such as African American ethnicity, lack of current employment income, and injection drug use moderated many of the apparent psychosocial disadvantages exhibited by parents.

Conclusions: Interventions specific to the psychosocial stressors facing families living with HIV are needed.


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Copyright © 2005 by the American Board of Family Medicine.