American teens worry about their parents? HIV risk

A study shows that children worry about their parents? exposure to HIV as much as the parents worry about risks to their children .

By Lisa Rabasca
Monitor staff

Preliminary results of two HIV-prevention studies aimed at New York City youth show that parents are essential in teaching adolescents HIV safety skills.

While one program helped parents and adolescents find common ground for discussing HIV prevention, the other prepared children whose parents were dying from AIDS-related illnesses. Preliminary results from these studies were presented at 'Family-based prevention programs for HIV-risk behavior in youth,' at APA?s 1998 Annual Convention in San Francisco.

Data were presented for the first 90 of 400 parents and their children, ages 10 to 13, participating in a study to encourage them to discuss HIV safety. The program targeted families living in the Lower East Side of New York City, where one in 10 adults above age 13 is infected with HIV, said Beatrice Krauss, PhD. She is deputy director of the Institute for AIDS Research and the Center for Drug Use and HIV Research at the National Development and Research Institutes, Inc., in New York City.

Fear of HIV

An initial interview with parents and youths revealed that children worry about their parents? exposure to HIV as much as parents worry about risks to their children, Krauss said. Both groups said they feared that someone they knew already was HIV positive but hadn?t told them, or that someone they knew might become HIV-positive. Although these concerns were strong, neither the parents nor the children discussed these fears with each other. Further, youths reported that if they did try to talk with their parents about sex or HIV, their parents would assume they were having sex and yell at them.

To help parents talk with their children about HIV, the National Development and Research Institutes offered them a four-session, 12-hour training program followed by several parent-child sessions. The training was based on Cornell University?s 'Talking with kids about AIDS' curriculum. Parents who were not randomly assigned to attend the training received an HIV-information booklet instead. The parent-only training sessions taught communication skills and provided opportunities for discussion. For example:

? Trainers demonstrated the difficulty of having a conversation with someone who is yelling by asking the parents to have a discussion with someone who was standing on a chair and using a megaphone to speak.

? Using role playing, parents practiced how they would respond if they found their children engaging in an unsafe behavior as well as how it would feel if their children found them doing something risky.

During the parent-child sessions, participants discussed how condoms can prevent HIV, how sexually transmitted diseases such as gonorrhea put people at risk for HIV transmission and how parents and children could stay safe, Krauss said.

At the end of the program, 69 percent of children whose parents were offered the intervention said they intended to use a condom every time that they had sex compared with 41.9 percent of the children whose parents received the information pamphlet, Krauss said.

When a parent has AIDS

The other study discussed at the session targeted the children of parents diagnosed with AIDS. About 300 parents and 430 youths in New York City participated in the 24-session program, which helped the parents disclose their terminal illness, make custody arrangements and say goodbye, said Mary Jane Rotheram-Borus, PhD, director of the Center for HIV Identification, Prevention and Treatment Services at the University of California in Los Angeles. Most parents in the study were single mothers, and their median age was 38.

The first part of the program focused on helping parents cope with being HIV positive and decide whether to tell their children about their infection. Parents who did tell their children participated in a series of parent-child sessions on resolving conflicts, dealing with drugs and alcohol, preventing pregnancy, encouraging safe sex, arranging for custody and saying goodbye.

Initially, the children who participated in the sessions and were told their parents were HIV positive were more distressed than the youths who didn?t know their parents were infected with HIV, Rotheram-Borus said. However, over time the children who knew their parents were HIV positive were better able to cope with their parents? illness.