Exploring the Moderating Role of Parent-Child Relationships in Stress, Depression, and Medication Adherence Among Women Living with HIV Open Access
Prepetit, Sylvie (Spring 2025)
Abstract
Background: In the United States, 1.2 million people are living with HIV, with women accounting for 22% of this population. Women living with HIV (WLWH) face unique biological and systemic disparities that persist across multiple levels, which can disrupt consistent medication adherence. For WLWH who have children, parenting can serve as a source of purpose and stress. Parenting stress and potential parent-child conflicts may exacerbate existing mental health challenges and impact on HIV medication adherence.
Purpose: This study explores how parent-child relationships influence stress and depression and their association with HIV medication adherence among WLWH. Guided by the social support theory, this study contributes to a more nuanced understanding of the dual role that children can play, as sources of both social support and stress, in the lives of WLWH.
Methods: A cross-sectional, secondary data analysis was employed with data sourced from the Women’s Adherence and Visit Engagement (WAVE), a sub-study of the Women’s Interagency HIV Study (WIHS). Parent-child relationship variables were assessed in four categories: child social support, child strain, parental dissatisfaction, and relationship equity. Moderation Analyses were conducted to examine whether these variables moderate the relationship between stress and adherence and between depression and adherence, using a significance threshold of p ≤ 0.05.
Results: Stress and depression were both significantly and negatively associated with antiretroviral therapy (ART) adherence. No interaction terms reached statistical significance, though the interaction in the adjusted model between depression and child strain approached significance (p = .057). Graphical representations of the interactions in both models suggested that relationship equity and caregiving imbalance may meaningfully shape adherence patterns.
Conclusion: While interaction effects were not statistically significant, notable trends suggest emotional support may buffer stress and depression, whereas child strain may amplify effects of depression. Relationship equity consistently presented as a factor that may warrant further exploration in studies aimed at supporting mothers, so that caregiving responsibilities do not become burdensome and lead to poor self-regulation or adverse health behaviors.
Table of Contents
Chapter 1: Introduction……………………………………………………………………………1
Chapter 2: Review of Literature………………………………………………………………….5
Chapter 3: Methodology……………………………………………………………………….…17
Chapter 4: Results………………………………………………….……………………………...24
Chapter 5: Discussion, Public Health Implications and Conclusion……………………28
References…………………………………………………………..………………………....…...35
Appendices……………………………………………………………………………………….....41
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