Peer Mentors for Early Adolescents
in HIV-Affected Families
- To conduct an efficacy trial of peer mentoring for early adolescents with HIV-ill parents.
- To determine the mechanisms (mediating variables) through which peer mentoring improves outcomes for the mentees, e.g., consistency and continuity of relationship; teaching/role modeling; emotional support/empathy; advocacy; and behavioral reinforcement.
- After the conclusion of the one-year efficacy trial, to examine the longer-term outcomes of peer mentoring through naturalistic longitudinal research for an additional two years.
Given that, in the United States, there are more than
120,000 youth with HIV-ill mothers (primarily single parents living
in inner-city neighborhoods), it is imperative to develop innovative
models of community support for these youths. With the introduction
of HAART therapy, larger proportions of these HIV-infected mothers are
raising their own children. However, HIV-affected families are characterized
by economic deprivation and substance abuse. Youth in these families
are of special developmental concern; they are vulnerable to all the
known risks stemming from their disadvantaged inner city environment
as well as the added risk resulting from their HIV-affected stressful
family situation. Parents/guardians are frequently disabled, preoccupied
or disoriented by their illness as well as by substance abuse, seriously
impairing the caretaking, guidance and support of their youngsters.
These children can suffer from powerful feelings of denial, depression,
anger, grief and abandonment and are at risk of poor developmental outcomes.
The importance of mentoring relationships for at-risk youth has been
lately "rediscovered," but suitable adult mentors are generally
not available for inner-city, minority youths. Peer mentoring, may prove
especially suitable for youth, since striving for autonomy (a developmental
task of adolescence) frequently (some argue inevitably) leads to separation
from parental influence. Consequently an intervention that may be especially
suitable for youth from HIV-affected families would be peer-mentoring
(an intervention that advances the interaction and identification with
positive peers). This study proposes peer mentoring as a practical and
potentially effective mentoring model for HIV-affected early adolescents.
Eligible families with youths aged 9-15 served by a community-based
HIV/AIDS outreach organization will be voluntarily randomly assigned
to two conditions: (a) experimental (n = 80) - a peer mentoring program
centered around 20 older, trained Jr. Peer Mentors with adult supervision,
plus regular services and referrals for parents/youths; or (b) control
(n = 80) - regular services and referrals for the families/youths, "as
usual" (The control families will be placed on a waiting list for
the mentoring program for one year.) Youth and family will be followed
up for three years. Primary youth behavioral outcomes are: psychological
functioning, academic adjustment, substance use, HIV risk behaviors,
delinquent/violent behaviors, peer relationships, prosocial activities,
coping/problem-solving. Family outcomes are: parent/guardian functioning;
improved permanency planning. The study becomes naturalistic after one
year because crossovers from the control to the mentoring group will
be permitted and some mentees who are doing well may be trained as mentors.
Mentors/Mentees meet as a group on Saturdays for discussion, educational
and recreational workshops and activities and have opportunities for
contact throughout the week. Mentors receive extended training that
includes on-going supervision and participation in a 12 session training
curriculum devoted to issues relevant to adolescents such as interpersonal
relationships, HIV, sex and STDs, substance use, conflict resolution,
stress management, and gender and power.
The study, by designing, developing, delivering and evaluating an indigenous peer mentoring model for HIV-affected youth - established and delivered by members of an at-risk community - will provide information on the feasibility and efficacy of such a model. Moreover, should the study intervention prove effective, the peer-mentoring model could be implemented across communities with high-risk youth. Like other studies of high-risk youth, findings will identify the constellation of family and peer risk and protective factors that are impacted by the intervention and that develop naturalistically through adolescent development.
Rosenblum, A. Magura S, Fong C, Cleland C, Norwood C, Casella D, Truell J, Curry P. Substance Use Among Young Adolescents in HIV-Affected Families: Resiliency, Peer Deviance, and Family Functioning. Substance Use and Misuse. 2005;40(5):581-603.
For additional information on this project, please contact us