title: Psychosocial functioning among HIV-affected youth and their caregivers in Haiti: implications for family-focused service provision in high HIV burden settings.
abstract: The study is an analysis of baseline data from a pilot psychosocial support intervention for HIV-affected youth and their caregivers in Haiti. Six sites in Haiti's Central Department affiliated with Partners In Health/Zanmi Lasante (PIH/ZL) and the Haitian Ministry of Health were included. Participants were recruited from a list of HIV-positive patients receiving care at PIH/ZL. The baseline questionnaire was administered from February 2006 to January 2007 with HIV-affected youth (n = 492), ages 10-17, and their caregivers (n = 330). According to findings at baseline, the youth reported high levels of anxiety, including constant fidgeting (86%), restlessness (83%), and worrying a lot (56%). Their parents/caregivers also reported a high level of depressive symptoms, such as low energy (73%), feeling everything is an effort (71%), and sadness (69%). Parents' depressive symptoms were positively associated with their children's psychological symptoms (odds ratio [OR] =1.6-2.4) and psychosocial functioning (OR =1.6 according to parental report). The significant levels of anxiety and depression observed among HIV-affected youth and their caregivers suggest that psychosocial interventions are needed among HIV-affected families in central Haiti and other high HIV burden areas. The results suggest that a family-focused approach to service provision may be beneficial, possibly improving quality of life, as well as psychosocial and physical health-related outcomes among HIV-affected youth and their caregivers, particularly HIV-positive parents.
authors.affiliation: Harvard Medical School, Department of Global Health and Social Medicine, Boston, Massachusetts 02115, USA. mary_smith-fawzi@hms.harvard.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: Smith Fawzi
authors.forename: Eddy
authors.initials: E
authors.lastname: Eustache
authors.forename: Catherine
authors.initials: C
authors.lastname: Oswald
authors.forename: Pamela
authors.initials: P
authors.lastname: Surkan
authors.forename: Ermaze
authors.initials: E
authors.lastname: Louis
authors.forename: Fiona
authors.initials: F
authors.lastname: Scanlan
authors.forename: Richard
authors.initials: R
authors.lastname: Wong
authors.forename: Michelle
authors.initials: M
authors.lastname: Li
authors.forename: Joia
authors.initials: J
authors.lastname: Mukherjee
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005190:Family / Q000523:psychology; D015658:HIV Infections / Q000523:psychology*; D006205:Haiti; D006296:Health Services; D006801:Humans; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011584:Psychology; D012944:Social Support; D011795:Surveys and Questionnaires