Dorie Gilbert, Ph.D.
Jeanne Tschann, Ph.D.
Duration: December, 2002 – Ongoing
The purpose of this study is to explore two major aspects of the lives of 12-16 year-old daughters of HIV-positive, African American mothers: (1) The nature and extent of communication between mothers and daughters as it relates to reducing HIV risk behavior for the daughters, and (2) Characteristics of the mother and daughter that potentially will impact the mental health, social functioning, and behavioral outcomes for the daughters.
BACKGROUND AND SIGNIFICANCE:
A significant and growing number of children (non HIV- infected) are considered HIV-affected by parental death or chronic illness from HIV/AIDS. Ironically, HIV-affected children and adolescents may themselves be at high risk for HIV-infection due to unresolved trauma and ineffective coping that may result in their own early or unsafe sexual practices and/or experimentation with drugs (Lewis, 1995). African American HIV-affected girls may be at especially high risk for HIV infection for four reasons. First, among all HIV-affected youth, African American adolescents are over-represented due to the fact that 63% of all HIV-positive women are African American (CDC, 2001), and most of these women are mothers. Second, gender differences found among HIV-affected adolescents indicate girls experience more emotional distress and internalizing behaviors (e.g., depression, anxiety) than boys (Rotheram-Borus & Stein, 1998). Moreover, feminist developmental theory predicts negative outcomes for daughters whose mother-daughter connections are impacted by stressful situations, such as a mother’s chronic illness (Gilligan, 1993). Third, African American girls, in general, are already at high risk for HIV infection due to sociocultural factors that place them in high risk situations. African-American girls account for 58% of new AIDS cases reported among U.S. youth between ages of 13 and 19, although they represent only 8% of American adolescents (CDC, 2001). Fourth, African American girls are the least likely across all ethnic groups to receive information about sexuality from their mothers or to receive accurate information from their mothers about HIV risk reduction behaviors (Dancy 2002, Wyatt, 1997). These concerns mount a case for looking further into the lives of HIV-affected African American girls, and this study will investigate the extent and nature of the risk to this vulnerable population.
No study, to date, has looked specifically at the nature and extent of HIV risk to early adolescent daughters of HIV-positive mothers. Do HIV-positive African American mothers transcend this silence and lack of knowledge to pass on HIV risk-reduction information to their daughters, thus, rendering the girls less vulnerable to HIV risks? Or are HIV-affected African American girls at high risk for HIV as a result of poor adjustment to mother’s HIV status, poor communication about sexuality, or other high risk situations. This study will explore characteristics of the mother, the daughter, and the mother-daughter dyad relationship that potentially will impact the mental health, social functioning, and behavioral outcomes for the daughters.
METHOD AND DESIGN:
This is primarily a qualitative study involving interviews with mother-daughter dyads. Mothers will be interviewed by Dr. Dorie Gilbert; daughters will be interviewed by a Research Assistant. The quantitative part of this study involves administering brief standardized scales to the mother-daughter dyads.
1. Qualitative interview data: Interview data will be analyzed following the analytical induction method (Andelman, 1981) based on the following three steps. First, after each set of interviews are completed, Dr. Gilbert and her research assistant will meet to discuss and document the general impressions of the interview process. Any emergent themes will be noted as well as any new areas of information not covered in the interview guide. Second, Dr. Gilbert will listen to each taped interview and document its general content according to responses given by the interviewee. As interviews are completed, Dr. Gilbert will record any recurrent patterns and emergent themes (Atkinson, 1995). Third, after reviewing each tape, Dr. Gilbert will have the tapes professionally transcribed. Dr. Gilbert will then check each transcript against the tape to note and correct any discrepancies. Each transcribed interview will be assigned a code ID number and then its data is entered into the QSR (Qualitative Solution and Research) NUDIST (Non-numerical Unstructured Data Indexing, Searching, and Theory-building) software program, a program which facilitates qualitative data analysis. According to this analytical induction methods, each case will be examined as a case in itself and as a part of the entire set. When all relevant patterns are identified by NUDIST, the transcripts will be re-examined to generate a list of all relevant patterns and themes emerging from the interviews.
2. Quantitative Data: Basic trend statistics will be recorded for demographic information, scores on the Child Behavioral Checklist (Parent and Child versions) and the Inventory of Parent and Peer Attachment (IPPA completed by daughters). Qualitative data will then be re-examined within the context of subgroups of quantitative data. For example, interviews for mother/daughter dyads where daughters scored lowest on IPPA scale (indicating poor mother-daughter relationship) will be reexamined for common recurrent patterns and emergent themes.
Keywords: child welfare, families, children, youth