• Context: Mothers living with HIV (MLH) and their children face predictable challenges: maintaining physical and mental health, parenting while ill, and addressing HIV-related stressors.
• Objective: To evaluate the efficacy of a family-based intervention over time; to contrast the life adjustments of HIV-affected families and their non-HIV-affected neighbors in the current treatment era.
• Design: Randomized controlled trial of MLH and a longitudinal comparison of MLH to a neighborhood cohort using random effect regression.
• Participants and Intervention: MLH (n = 339) and their school-age children (n = 259) were randomly assigned to receive 1) an intervention of 16 sessions in a cognitive-behavioral, small-group format; or 2) control. MLH and their children were compared to non-HIV-affected families recruited at shopping markets. Participant retention was high: 84% at 6 months, 83% at 12 months, and 78% at 18 months.
• Main Outcome Measures: Family functioning and conflict, mental and physical health, sexual behavior, and substance use.

Inclusion Criteria for Intervention/Control, mother living with HIV:

• Mother or primary female caregiver
• Enrolled in HIV-related clinical cares
• At least one child between the age of 6 and 20 years

Inclusion Criteria for neighborhood control, non-HIV-affected mother:

• Mother or primary female caregiver
• not HIV-positive
• At least one child between the age of 6 and 20 years

Exclusion Criteria (Intervention/Control/Neighborhood):

• Mother less than 18 years old
• Unable or willing to give informed consent
• Psychosis or neurological damage as judged by the investigator in consultation with clinical supervisor