Abstract:
OBJECTIVE : To assess the efficacy of an intervention designed to promote resilience in young
children living with their HIV-positive mothers.
DESIGN / METHODS : HIV-positive women attending clinics in Tshwane, South Africa and their
children, aged 6 - 10 years, were randomised to the intervention (I) or standard care (S). The
intervention consisted of 24 weekly group sessions led by community care workers. Mothers and
children were in separate groups for 14 sessions, followed by 10 interactive sessions. The
primary focus was on parent-child communication and parenting. Assessments were completed
by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses
were used to assess change over time.RESULTS : Of 390 mother-child pairs, 84.6% (I:161 & S:169) completed at least two interviews
and were included in the analyses. Children’s mean age was 8.4 years and 42% of mothers had
been ill in the prior three months. Attendance in groups was variable: only 45.7% attended >16
sessions. Intervention mothers reported significant improvements in children’s externalizing
behaviors (ß=-2.8, P=0.002), communication (ß=4.3, P=0.025) and daily living skills (ß=5.9,
P=0.024), while improvement in internalizing behaviors and socialization was not significant
(P=0.061 and 0.052 respectively). Intervention children reported a temporary increase in anxiety
but did not report differences in depression or emotional intelligence.
CONCLUSIONS : This is the first study demonstrating benefits of an intervention designed to
promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context, and has the potential to benefit large numbers of
children, if it can be widely implemented.
