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Research ArticleOriginal Research

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

Risë B. Goldstein, Mallory O. Johnson, Mary Jane Rotheram-Borus, Sheri B. Kirshenbaum, Rogério M. Pinto, Lauren Kittel, Willo Pequegnat, Joanne D. Mickalian, Lance S. Weinhardt, Jeffrey A. Kelly, Marguerita Lightfoot and ; the National Institute Mental Health Healthy Living Project Team
The Journal of the American Board of Family Practice September 2005, 18 (5) 362-373; DOI: https://doi.org/10.3122/jabfm.18.5.362
Risë B. Goldstein
PhD, MPH
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Mallory O. Johnson
PhD
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Mary Jane Rotheram-Borus
PhD
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Sheri B. Kirshenbaum
PhD
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Rogério M. Pinto
PhD, LMSW
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Lauren Kittel
PsyD
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Willo Pequegnat
PhD
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Joanne D. Mickalian
MA
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Lance S. Weinhardt
PhD
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Jeffrey A. Kelly
PhD
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Marguerita Lightfoot
PhD
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Article Figures & Data

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    Table 1.

    Sociodemographic Characteristics of Adults Living with HIV by Parental Status (N = 3810)*

    CharacteristicTotal Sample (%)Custodial Parents of Minor Children (n = 401) (%)Noncustodial/Parents of Grown Children (n = 1319) (%)Nonparents (n = 2090) (%)PValue
    Age in years, mean ± SD41.5 ± 7.638.9 ± 6.243.4 ± 7.440.7 ± 7.7<.0001
    Behavioral risk group<.0001
        MSM45.66.719.369.7
        IDU8.11.86.410.3
        Women27.172.641.39.4
        Heterosexual men19.219.033.010.6
    Ethnicity<.0001
        African American48.359.662.836.9
        Hispanic19.125.917.219.0
        White25.710.213.936.1
        Other7.04.26.28.0
    Currently in a cohabiting primary relationship23.540.424.919.3<.0001
    Educational attainment < high school graduation26.240.534.518.2<.0001
    Currently residing in own house or apartment62.877.057.863.2<.0001
    Current employment status<.0001
        Legal job, paying income taxes15.615.510.818.7
        Legal job, paid “under the table”13.613.012.315.6
        Illegal job0.91.31.00.8
    Receives public assistance32.554.136.925.5<.0001
    • * Information on parental status is missing for 8 participants.

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    Table 2.

    Medical Status and Health Care Utilization among Adults Living with HIV by Parental Status (N = 3810)*

    CharacteristicTotal SampleCustodial Parents of Minor Children (n = 401)Noncustodial/Parents of Grown Children (n = 1319)Nonparents (n = 2090)P Value
    Years since learned HIV serostatus, mean ± SD8.4 ± 4.77.7 ± 4.18.1 ± 4.58.8 ± 4.8<.0001
    Last self-reported CD4 count <20020.4%15.1%20.7%21.2%.0309
    Last viral load detectable (self-report)59.3%54.7%58.1%61.0%.0377
    HIV-related symptom count, mean ± SD12.4 ± 5.712.4 ± 5.912.3 ± 5.912.6 ± 5.5.3145
    Distress due to HIV-related symptoms, mean ± SD†2.8 ± 0.52.9 ± 0.52.9 ± 0.52.8 ± 0.5<.0001
    Currently taking antiretrovirals74.7%72.6%73.7%75.7%.2378
    Adherent to all medications, past 3 days63.7%53.0%63.5%65.8%.0002
    Any missed medical appointments, past 3 months47.7%53.0%48.9%46.1%.0418
    • * Information on parental status is missing for 8 participants.

    • † Rated 1 (doesn’t bother at all) to 4 (bothers a great deal).

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    Table 3.

    Crude and Adjusted Associations of Mental Health and Adjustment Measures with Parental Status (N = 3810)*

    MeasureTotal SampleCustodial Parents of Minor Children (n = 401)Noncustodial/ Parents of Grown Children (n = 1319)Nonparents (n = 2090)Adjusted Odds Ratios or Regression Coefficients (95% CI)†
    Custodial vs. nonparentsNoncustodial vs. nonparents
    Beck Depression Inventory score, mean ± SD12.9 ± 9.013.1 ± 9.313.0 ± 9.112.8 ± 8.8
        MSM0.88 (−2.15, 3.90)0.60 (−0.48, 1.69)
        IDU13.10 (6.64, 19.57)1.43 (−0.58, 3.44)
        Women−0.66 (−2.12, 0.80)−0.75 (−2.03, 0.52)
        Heterosexual men0.33 (−1.76, 2.42)1.12 (−0.19, 2.43)
    Frequent† substance use (%)31.622.733.232.4
        African American0.63 (0.43, 0.92)0.87 (0.68, 1.13)
        Hispanic0.46 (0.21, 0.98)1.40 (0.94, 2.09)
        White0.84 (0.51, 2.72)1.52 (1.03, 2.25)
        Other ethnicities0.87 (0.65, 1.16)1.06 (0.58, 1.94)
    Substance abuse treatment, past 3 months (%)46.141.759.138.7
        MSM1.06 (0.46, 2.43)1.51 (1.14, 2.01)
        IDU3.52 (0.39, 31.62)2.49 (1.35, 4.59)
        Women0.47 (0.32, 0.69)1.24 (0.88, 1.75)
        Heterosexual men0.93 (0.54, 1.61)1.36 (0.64, 1.26)
    STAI score, mean ± SD36.3 ± 11.037.2 ± 11.436.0 ± 10.736.3 ± 11.1.
        African American, no current employment income4.40 (2.60, 6.20)2.19 (1.00, 3.38)
        African American, current employment income1.34 (−1.04, 3.72)1.68 (0.62, 3.99)
        STAI score >42 (%)26.529.825.826.3
            African American2.20 (1.51, 3.22)1.60 (1.21, 2.10)
            Hispanic0.46 (0.21, 0.98)1.40 (0.94, 2.09)
            White0.84 (0.51, 2.72)1.52 (1.03, 2.25)
            Other ethnicities0.49 (0.15, 1.62)1.06 (0.58, 1.94)
    Currently taking anti-anxiety medication (%)19.719.217.121.5
        No current welfare income0.85 (0.53, 1.35)0.99 (0.77, 1.28)
        Current welfare income1.79 (1.10, 2.92)1.01 (0.70, 1.46)
    Positive States of Mind Scale, mean ± SD12.9 ± 3.512.9 ± 3.613.0 ± 3.612.9 ± 3.4−0.48 (−0.89, −0.07)−0.24 (−0.51, 0.03)
    Coping self-efficacy, mean ± SD6.6 ± 1.86.7 ± 1.86.7 ± 1.86.6 ± 1.8
        African American, MSM−0.94 (−1.59, −0.28)−0.56 (−0.82, −0.30)
        African American, IDU−1.40 (−2.80, 0.00)−0.85 (−1.32, −0.38)
        Hispanic, women0.46 (0.01, 0.91)0.55 (0.18, 0.92)
        White, women0.37 (−0.22, 0.93)0.51 (0.13, 0.89)
        Other ethnicities, MSM−1.00 (−2.04, 0.03)−0.57 (−1.05, −0.10)
        Other ethnicities, IDU−1.47 (−3.10, 0.16)−0.86 (−1.46, −0.27)
    • * Information on parental status is missing for 8 participants.

    • † Defined as alcohol > daily, any other drug > 4 times weekly, or any injection in the past 3 months.

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The Journal of the American Board of Family Practice: 18 (5)
The Journal of the American Board of Family Practice
Vol. 18, Issue 5
1 Sep 2005
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Psychological Distress, Substance Use, and Adjustment among Parents Living with HIV
Risë B. Goldstein, Mallory O. Johnson, Mary Jane Rotheram-Borus, Sheri B. Kirshenbaum, Rogério M. Pinto, Lauren Kittel, Willo Pequegnat, Joanne D. Mickalian, Lance S. Weinhardt, Jeffrey A. Kelly, Marguerita Lightfoot
The Journal of the American Board of Family Practice Sep 2005, 18 (5) 362-373; DOI: 10.3122/jabfm.18.5.362

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Psychological Distress, Substance Use, and Adjustment among Parents Living with HIV
Risë B. Goldstein, Mallory O. Johnson, Mary Jane Rotheram-Borus, Sheri B. Kirshenbaum, Rogério M. Pinto, Lauren Kittel, Willo Pequegnat, Joanne D. Mickalian, Lance S. Weinhardt, Jeffrey A. Kelly, Marguerita Lightfoot
The Journal of the American Board of Family Practice Sep 2005, 18 (5) 362-373; DOI: 10.3122/jabfm.18.5.362
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    • Abstract
    • Role Theory, Mental Health, and Adjustment in HIV+ Parents
    • Role Negotiation, Role Overload, and Role Conflict
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    • The NIMH Healthy Living Trial Group
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