Methods: Focus groups with 15 MLH and individual interviews with 13 of their children helped identify the ways in which our original evidence-based intervention could be modified to fit the needs of this population while maintaining core intervention components. A community advisory board (n = 11), consisting of MLH, staff from organizations serving MLH, facilitators familiar with the original intervention, and adolescent children of MLH, provided feedback on the modified intervention content. A small pilot of Ms. Now was then conducted with 12 MLH-adolescent dyads to assess participant engagement and satisfaction. Preliminary efficacy was also examined via pre-/post-intervention assessments of main intervention targets and outcomes.
Results: Formative data indicated MLH were highly motivated to discuss sexual risks with their adolescents, yet some faced challenges to disclosing protective information about their HIV status, particularly with sons. Many had prior histories of addiction which had caused separations with their child. These formative results resulted in several changes to the intervention. Participants in the pilot found Ms. Now to be highly acceptability and had only a few suggestions for programmatic changes. Promising preliminary efficacy trends were found, including increased relationship quality, parental monitoring, and discussions about mothers’ HIV status.
Conclusions: Our findings highlight the importance of structured program adaptation, as well as the feasibility of a parent-based HIV prevention approach for families affected by maternal HIV infection.