Adolescents With HIV: Attachment, Depression, and Adherence By Er ...

Moreover, the risk of depression increases dramatically if a childhood loss interfaces with life-threatening events, enduring problems, or stressful home environments (Greenberg et al., 1990). Many perinatally HIV-infected adolescents have experienced the loss of one or both parents to HIV/AIDS and have experienced the challenge of multiple caretaking transitions, including foster care placement and/or extended family care. In addition, the majority of HIV-infected adolescents live in large urban environments and may be confronted with high levels of daily life stress, secondary to poverty and limited resources in inner-city communities (Mellins, Smith, O’Driscoll, et a1., 2003).

These losses and transitions would increase stress on anyone. The additional stress associated with one’s own chronic illness, as well as unique factors specific to HIV/AIDS, further contribute to the risk of depression. For example, according to the research, maternal depression and a stigmatizing, life-threatening chronic illness increase an adolescent’s risk of depression threefold (Dulcan, Martini, & Lake, 2004; Greenberg et al., 1990). Maternal death before the child reaches the age of 11, the absence of an adequate caregiver after the loss of the mother, and family conflict also contribute to the risk for depression (Armsden & Greenberg, 1987; Greenberg et al., 1990; Harris & Bifulco, 1991), and are not uncommon among children with HIV infection/AIDS.