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Maternal HIV Stigma and Child Adjustment: Qualitative and Quantitative Perspectives

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Abstract

Globally, over 36 million people are living with HIV, and 51% are women, most of whom are of childbearing age. Children of mothers with HIV exhibit more adjustment problems than their demographically similar peers. Using mixed methods, this study examined associations between mothers’ HIV stigma and their children’s functioning. As part of a multi-site study in Georgia and California, participants included 181 HIV-positive mothers and one of their 6- to 14-year-old children. Mothers reported on children’s psychological adjustment, their own anxiety, and their perceived HIV stigma. Children reported on parent-child relationship quality. Following the quantitative portion of the study, 14 mothers and 13 children who knew their mothers were HIV positive completed in-depth qualitative interviews addressing the impact of HIV disclosure on family relationships. Hierarchical regression analyses found that parent-child relationship quality, maternal anxiety, and HIV stigma were significantly associated with child adjustment difficulties. HIV stigma predicted child adjustment problems after accounting for the role of parent-child relationship and maternal anxiety. Most mothers and some children in the qualitative portion of the study discussed the impact HIV stigma on their lives. In all, despite efforts to decrease HIV stigma, it continues to affect the lives of those with the virus and their families. Interventions, then, should not only focus on the parent-child relationship and maternal anxiety when attending to child functioning in families affected by HIV, but should also target coping skills for mitigating the impact of stigma while continuing efforts to reduce HIV-related stigma.

Highlights

  • Maternal HIV stigma is significantly associated with child adjustment difficulties.

  • HIV stigma persists as a significant concern for families affected by maternal HIV.

  • Qualitative reports of HIV stigma are consistent with ones from over 15 years ago.

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Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by S.J.K., A.R., N.G., L.A., and L.C. The first draft of the manuscript was written by S.J.K., A.R., N.G., L.A., and L.C., and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

Funding

Research reported in this manuscript was supported by the National Institute of Mental Health by Grant Numbers 5R01MH094233 (PI: L.P.A.), 5R01MH094148 (PI: M.T.S., and F31MH109370 (PI: N.M.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychology, Georgia State University, Atlanta, GA, 30303-5010, USA

    Sae-Jin Kim, Abigail Robbertz, Lisa P. Armistead & Lindsey L. Cohen

  2. Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA

    Nada M. Goodrum

  3. Department of Psychiatry, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA

    Marya T. Schulte & Debra A. Murphy

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  1. Sae-Jin Kim
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Correspondence to Sae-Jin Kim.

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Ethics Approval and Consent to Participate

The Institutional Review Boards of Georgia State University and the University of California, Los Angeles, approved this study in accordance with ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. In this study, we obtained informed consent and assent from all adult and child participants, respectively.

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All adult and child participants in this study signed informed consent and assent, respectively, regarding the publication of their deidentified data.

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Kim, SJ., Robbertz, A., Goodrum, N.M. et al. Maternal HIV Stigma and Child Adjustment: Qualitative and Quantitative Perspectives. J Child Fam Stud 30, 2402–2412 (2021). https://doi.org/10.1007/s10826-021-02034-x

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