Maternal HIV Stigma and Child Adjustment: Qualitative and Quantitative Perspectives.

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.