Family mechanisms of structural ecosystems therapy for HIV-seropositive women in drug recovery.
OBJECTIVE
Examined the effects of Structural Ecosystems Therapy (SET), a family intervention for women living with HIV or AIDS, compared to a psycho-educational health group (HG) intervention, and reciprocal relationships between women and family members.


METHODS
Women (n = 126) and their family members (n = 269) were randomized to one of two conditions and assessed every 4 months for 12 months. Family functioning, drug use, and psychological distress was reported by multiple family members.


RESULTS
Multilevel growth curve modeling showed a different family functioning trajectory between SET and HG, B = -0.05, SE = 0.02, p < .01. There was no intervention effect on the trajectory of family-level drug abstinence or psychological distress, but there was a significant difference in the trajectory of psychological distress after controlling for change in family functioning, B = -0.28, SE = 0.13, p < .05. There was an indirect effect from treatment through change in family functioning to change in psychological distress, B = 0.29, SE = 0.12, p < .05. With respect to reciprocal effects, family drug abstinence significantly predicted women's abstinence 4 months later, B = 0.22, SE = 0.06, p < .001.


CONCLUSIONS
Findings demonstrated the interdependence of family members and the impact of family in relapse prevention and partially supported SET's potential for maintaining family functioning and well-being for women living with HIV or AIDS in drug recovery.
Center of Excellence for Health Disparities Research: El Centro, School of Nursing and Health Studies, University of Miami, Coral Gables, FL 33124, USA. vmitrani@miami.edu
Victoria B
VB
Mitrani
Brian E
BE
McCabe
Myron J
MJ
Burns
Daniel J
DJ
Feaster
D000163:Acquired Immunodeficiency Syndrome; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005190:Family / Q000523:psychology*; D005192:Family Health; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000523:psychology; D006679:HIV Seropositivity / Q000451:nursing* / Q000523:psychology; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013315:Stress, Psychological; D019966:Substance-Related Disorders / Q000451:nursing* / Q000523:psychology; D055815:Young Adult