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 are at risk for behavioral problems. Disruptive child behavior can lead to serious substance abuse, incarceration, and anxiety and depression. MLH report compromised parenting skills, and research demonstrates poor child outcomes. Based on PCIT, PC-CARE reshapes parent-child interactions, improving maternal-child relationships and child behavior, and decreasing maternal stress. 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. For MLH, positive family functioning improves child resilience, while negative functioning leads to child risk behavior. At MCA, bilingual, bicultural staff, achieve 80% follow-up ideal for testing interventions for later dissemination. Although effective for mothers demographically like ours, 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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