Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti

Michelle Li, Theresa Betancourt, Eddy Eustache, Catherine Oswald, Ermaze Louis, Joia Mukherjee, Pamela Surkan, Mary C. Smith Fawzi

Research output: Contribution to journalArticle

Abstract

The present study aims to: (1) estimate the levels of internalizing symptoms and externalizing behaviors among youth affected by HIV in central Haiti; and (2) examine the risk and protective factors associated with these outcomes to identify potential areas of intervention for HIV-affected youth. Baseline data for 492 youth affected by HIV (ages 10-17) and their 330 caregivers were collected for a pilot study of a psychosocial support intervention. Participants were recruited from a list of HIV-positive patients receiving care at Partners In Health/Zanmi Lasante clinic sites. Internalizing and externalizing behaviors were assessed using the Strengths and Difficulties Questionnaire. Demographic, economic, and social indicators were collected using a structured questionnaire administered by trained social workers. Youth affected by HIV in central Haiti displayed high levels of internalizing and, to a lesser degree, externalizing symptoms. Multivariate regression analysis demonstrated risk factors most strongly associated with internalizing symptoms (socioeconomic status, parental depressive symptoms) and externalizing behaviors (household living arrangements, such as living with a stepparent). Social support had a protective effect on externalizing behaviors for both caregiver (β = -0.03, p = 0.01) and self-report (β = -0.05, p <0.0001). High levels of psychological distress were observed in this population, especially with respect to internalizing outcomes. Interventions should address the economic security, mental health, and access to antiretroviral therapy for families affected by HIV, as well as emphasize the importance of building supportive caregiver-child relationships to decrease the psychological symptoms and impact of other life stressors experienced by youth affected by HIV in Haiti and similar resource-limited settings.

Original languageEnglish (US)
Pages (from-to)995-999
Number of pages5
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume27
Issue number8
DOIs
StatePublished - Aug 3 2015

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Haiti
HIV
caregiver
Caregivers
psychosocial care
social indicators
questionnaire
life situation
Economics
Psychology
multivariate analysis
social worker
economics
Family Therapy
social support
social status
regression analysis
mental health
Protective Factors
Social Class

Keywords

  • adolescents
  • caregivers
  • Haiti
  • HIV-affected
  • mental health
  • youth

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Social Psychology
  • Medicine(all)

Cite this

Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti. / Li, Michelle; Betancourt, Theresa; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Mukherjee, Joia; Surkan, Pamela; Smith Fawzi, Mary C.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 27, No. 8, 03.08.2015, p. 995-999.

Research output: Contribution to journalArticle

Li, Michelle ; Betancourt, Theresa ; Eustache, Eddy ; Oswald, Catherine ; Louis, Ermaze ; Mukherjee, Joia ; Surkan, Pamela ; Smith Fawzi, Mary C. / Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2015 ; Vol. 27, No. 8. pp. 995-999.
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