A qualitative longitudinal study of resilience in internationally adopted children with perinatally-acquired HIV

ABSTRACT

Relatively few children are born with HIV in this country, however, evidence suggests that a new population of U.S. children living with perinatally-acquired HIV are emerging: internationally adopted children. This unique population has intersecting identities that place them at risk for stigma, discrimination, and adverse mental health outcomes. This longitudinal study explores parental perspectives of their child’s resilience across various settings including school, community, doctors’ offices, and at home. Parents of internationally adopted children with perinatally-acquired HIV (IACP) were recruited through snowball sampling from two tertiary care hospitals and closed Facebook groups. From 2018 to 2021, 11 parents each participated in three semi-structured interviews annually. Parent interviews focused on 12 IACP, (mean age at time of adoption = 5.86 years, range 7 months to 15 years). At the time of the parent’s first interview, mean age of IACP was 9.62 years (range 4 to 18 years). Five IACP were female (42%), and seven were male (58%). Interviews were analyzed using the Sort, Sift, Think, Shift qualitative approach. Results from the three parent interviews suggest that parents of IACP are crucial in fostering resilience through open conversations about HIV and community challenges. Parents highlighted stigmatization around HIV in their community and with friends. Parents further revealed techniques they used to promote resilience, such as strengthening teacher and IACP relationships. Additionally, they discussed how IACP showed resilience in medical settings by tolerating blood work and developing medication independence through the support of their healthcare providers. Future research should prioritize engaging with IACP to gather their perspectives to further support their growth and development.

KEYWORDS:

• Resilience
• internationally adopted children
• perinatally-acquired HIV
• adoptive parents

Acknowledgments

We would like to thank the families for sharing their experiences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding was provided by Elon University’s Leadership Prize and the Undergraduate Research Program.

Notes on contributors

Cynthia D. Fair

Cynthia D. Fair, LCSW, DrPH is a professor of Public Health Studies at Elon University. Her clinical and research interests include HIV-infected and affected youth and women, as well as HIV-related stigma and discrimination. Her most recent research is focused on the reproductive decisions of youth with perinatally-acquired HIV infection as well as internationally adopted children living with HIV.

Sydney J. Barlow

Sydney Barlow graduated from Elon University with bachelor’s degree in Public Health Studies. Her research interests include internationally adopted children living with HIV and health care consultation.