We propose an open, lagged trial of a 6-week, evidence-based, parenting intervention. For children (28 years) of mothers living with HIV (MLH), PC-CARE will: 1) reduce disruptive behavior; 2) improve parenting skills; 3) improve mother-child relationships; 4) decrease maternal stress. Two groups of 6 HIV+ mothers and their HIV- children will receive PC-CARE. Randomized to immediate or lagged care, 6 dyads receive treatment, while the lagged group is waitlisted. After 6 weeks, all are retested to compare PC-CARE to control. After a three-month delay, all are tested again; the waitlisted receive treatment, then tested to compare pre/post outcomes in n=12 and maintenance of effects in n=6. Maternal HIV biomarkers are measured before and after treatment using existing records. Children of MLH, neglected in the HIV/AIDS response [1,2] are at risk for behavioral problems [3,4]. Disruptive child behavior can lead to serious substance abuse, incarceration, and anxiety and depression [5,6,7,8]. MLH report compromised parenting skills [9], and research demonstrates poor child outcomes [10,11]. Based on PCIT, PC-CARE reshapes parent-child interactions [12], improving maternal-child relationships and child behavior, and decreasing maternal stress [13]. Low SES Latina mothers at USC's Maternal, Child and Adolescent (MCA) HIV clinic--LA County's designated HIV perinatal center--face difficulties with employment, health care, material resources, drug use, and violence [14]. For MLH, positive family functioning improves child resilience, while negative functioning leads to child risk behavior [15,16,17]. At MCA, bilingual, bicultural staff, achieve 80% follow-up ideal for testing interventions for later dissemination.      Although effective for mothers demographically like ours [18], neither PCIT nor PC-CARE has been evaluated for medically ill mothers. We have submitted proposals to HRSA for similar projects. Reviewers requested pilot data, which we now hope to collect.

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