MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.

Self-concept was measured using the Tennessee Self-Concept Scale (TSCS). The 20-item scale measures children's perception of identity, self-satisfaction and other behaviors. Each item was rated on a 5-point scale: 1= always false, 2=usually false, 3=sometimes true/sometimes false, 4=usually true and 5= always true. Min/max values: 20-100. Ten items in the inverse direction were reverse coded to create summated scores, with higher scores indicating higher levels of child self-concept. Scores at 6-months are reported.

Hopelessness was measured using the Beck Hopelessness Scale (BHS). The 20-item scale measures children's hopelessness and pessimistic attitudes toward the future. Items have a "true" or "false" response coded as "1" or "0" respectively. Nine items with positive wording were reverse coded to create a summated score for the entire scale. Min/max values: 0-20, with higher scores indicating higher levels of hopelessness. Scores at 6-months are reported.

Child PTSD was measured using 31 items from the abbreviated Childhood post-traumatic Stress Reaction Index (CPTS-RI). Participants were asked about reactions people sometimes have after very bad things happen and how this was applicable to them in the past month. Responses were rated on a 5-point Likert scale, with 0= None, 1= Little (1-2 days a week), 2 = some (2-3 days a week), 3 =Much (2 days a month) and 4 =most (Almost every day). Min/max values: 0-124. Summated scores were created with higher scores indicating higher levels of child PTSD symptoms. Scores at 6-months are reported.

Child self-reported adherence was assessed using three items: 1) "In the last 30 days, on how many days did you miss at least one dose of your HIV medications (range: 0-30 days)?" 2) "In the last 30 days, how often did you take your HIV medicine in the way you were supposed to (never to always)?" and 3) "In the last 30 days, how good a job did you do at taking your HIV medicine in the way you were supposed to (very poor - excellent)"? Responses were linearized into a continuous scale ranging from 0-100, with low scores representing poor adherence and 100 representing perfect adherence. Scores at 6-months are reported.

Engagement in sexual risk behaviors was measured by asking a respondent whether they had engaged in unprotected sex, coded as "yes" or "no". Number of participants who responded "yes" at 6-months are reported.

Intentions to engage in sexual risk behaviors were assessed by asking respondents to rate how 5 sexual activity-related statements applied to them. Items were rated on a 5-point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time and 5=always. Min/max values: 5-25, with higher scores indicating high intentions to engage in sexual risk-taking behaviors. Scores at 6-months are reported.

Child-caregiver support was measured using 17 items from the Social Support Behaviors Scale (SS-BS) scale. Respondents were asked to rate the adults they live with, on a 5-point Likert scale, with 1= never, 2 = sometimes, 3=about half of the time, 4=most of the time, and 5= always. Min/max values: 17-85. Summated scores were created with high scores indicating high levels of perceived support from caregivers. Scores at 6-months are reported.

Child's quality of friendships was measured using 21-items from the Friendship Qualities Scale. This multidimensional measurement scale assesses the quality of children's relationships with their best friends via several aspects, including closeness, help, safety and closeness. Respondents were asked to rate how each statement applied to them. Responses were rated on a 5- point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time, and 5= always. Min/max values: 21-105, with high scores indicating high quality friendship levels. Scores at 6-months are reported.

Child loneliness was assessed using the UCLA Loneliness Scale. The 20-item scale measures one's subjective feelings of loneliness as well as feelings of social isolation. Responses were rated on 4-point Likert scale with 3= I often feel this way, 2= I sometimes feel this way, 1 = I rarely feel this way, and 0=I never feel this way. Min/max values: 0-60, with high scores indicating higher levels of social isolation. Scores at 6-months are reported.

Caregiver mental health functioning was assessed using 34-items from the Brief Symptom Inventory (BSI). The scale measures symptoms of anxiety, somatization and depression. Respondents were asked to rate how they felt emotionally, on a 5-point Likert scale, with 1=Never true, 2=rarely true, 3= true sometimes, 4= true most of the time and 5=always true. Min/max values: 34-170, with higher scores representing higher levels of caregiver mental distress. Scores at 6-months are reported.

Parenting stress was measured by 33 items from the Parenting Stress Index (PSI). The 33-item scale assesses symptoms related to parental distress, difficult child, and caregiver-child dysfunctional relationships. Respondents were asked to rate their parenting stress, on a 4-point Likert scale, with 1=strongly disagree, 2=somewhat disagree, 3=somewhat agree and 4=strongly agree. The theoretical range for this scale is 33-132, with high scores indicating high levels of parenting stress. Score at 6-months are reported.

Multiple Family Group (MFG): MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.

Total of all reporting groups

The study recruited both children and their caregivers (n=89 dyads). Total includes both children and caregivers.

Sex was analysed separately for children and caregivers.

Race was analyzed separately for children and caregivers.

Child and Caregiver Region on enrollment (N= 89 child-caregiver dyads). Number of children = 89; number of caregivers = 89

Child HIV Stigma was measured by the HIV Stigma Scale (HSS). The 40-item scale measures stigma and psychosocial aspects of having HIV. Responses were rated on a 4-point scale with 1= strongly agree, 2= agree, 3=disagree and 4=strongly disagree. Items in the inverse direction were reverse coded to create summated scores, with higher scores indicating high levels of HIV-related stigma. The theoretical range for this scale is 40-160.

Only child reports were analyzed.

Child HIV Shame was measured by the Shame Questionnaire. The 8-item scale is used to assess child's feelings of shame on a 3-point scale, with 0 =not true, 1 = somewhat true and 2 =very true. Summated scores were created with higher scores representing high levels of HIV-associated shame. The theoretical range is 0-16.

Only child reports were analyzed.

Stigma by association (Child reports) was measured using 10-items from the Brief Stigma-by Association Scale. The scale measures experiences and consequences of associated stigma, on a 3-point scale with 0= Not at all, 1= Sometimes and 2= All the time. Summated scores were created with higher scores indicating high levels of stigma-by association. The theoretical range for the scale is 0-20.

Only child reports were analyzed.

The Child Depression Inventory (CDI) was used to measure children's depressive symptoms. Respondents were asked to mark a statement that best described their feelings during the past 2 weeks. Each of the 14-items on the CDI has three response options that correspond to varying levels of symptomology for clinical depression. The theoretical range for this scale is 0-28, with higher scores representing high levels of depressive symptoms.

Only child reports were analyzed.

Self-concept was measured using the Tennessee Self-Concept Scale (TSCS). The 20-item scale measures children's perception of identity, self-satisfaction and other behaviors. Each item was rated on a 5-point scale: 1= always false, 2=usually false, 3=sometimes true/sometimes false, 4=usually true and 5= always true (theoretical range: 20-100). Ten items in the inverse direction were reverse coded to create summated scores, with higher scores indicating higher levels of child self-concept.

Only child reports were analyzed.

Hopelessness was measured using the Beck Hopelessness Scale (BHS). The 20-item scale measures children's hopelessness and pessimistic attitudes toward the future. Items have a "true" or "false" response coded as "1" or "0" respectively. Nine items with positive wording were reverse coded to create a summated score for the entire scale. The theoretical range for the BHS is 0-20, with higher scores indicating higher levels of hopelessness.

Only child reports were analyzed.

Child PTSD was measured using 31 items from the abbreviated Childhood post-traumatic Stress Reaction Index (CPTS-RI). Participants were asked about reactions people sometimes have after very bad things happen and how this was applicable to them in the past month. Responses were rated on a 5-point Likert scale, with 0= None, 1= Little (1-2 days a week), 2 = some (2-3 days a week), 3 =Much (2 days a month) and 4 =most (Almost every day). The theoretical range is 0-124. Summated scores were created with higher scores indicating higher levels of child PTSD symptoms.

Only child reports were analyzed.

Child self-reported adherence was assessed using three items: 1) "In the last 30 days, on how many days did you miss at least one dose of your HIV medications (range: 0-30 days)?" 2) "In the last 30 days, how often did you take your HIV medicine in the way you were supposed to (never to always)?" and 3) "In the last 30 days, how good a job did you do at taking your HIV medicine in the way you were supposed to (very poor - excellent)"? Responses were linearized into a continuous scale ranging from 0-100, with low scores representing poor adherence and 100 representing perfect adherence.

Only child reports were analyzed.

Engagement in sexual risk behaviors was measured by asking a respondent whether they had engaged in unprotected sex, coded as "yes" or "no".

Only child reports were analyzed.

Intentions to engage in sexual risk behaviors were assessed by asking respondents to rate how 5 sexual activity-related statements applied to them. Items were rated on a 5-point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time and 5=always. The theoretical range for this scale is 5-25, with higher scores indicating high intentions to engage in sexual risk-taking behaviors.

Only child reports were analyzed.

Child-caregiver support was measured using 17 items from the Social Support Behaviors Scale (SS-BS) scale. Respondents were asked to rate the adults they live with, on a 5-point Likert scale, with 1= never, 2 = sometimes, 3=about half of the time, 4=most of the time, and 5= always. The theoretical range for this scale is 17-85. Summated scores were created with high scores indicating high levels of perceived support from caregivers

Only child reports were analyzed.

Child's quality of friendships was measured using 21-items from the Friendship Qualities Scale. This multidimensional measurement scale assesses the quality of children's relationships with their best friends via several aspects, including closeness, help, safety and closeness. Respondents were asked to rate how each statement applied to them. Responses were rated on a 5- point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time, and 5= always. The theoretical range for this scale is 21-105, with high scores indicating high quality friendship levels.

Only child reports were analyzed.

Child loneliness was assessed using the UCLA Loneliness Scale. The 20-item scale measures one's subjective feelings of loneliness as well as feelings of social isolation. Responses were rated on 4-point Likert scale with 3= I often feel this way, 2= I sometimes feel this way, 1 = I rarely feel this way, and 0=I never feel this way. The theoretical range for this scale is 0-60, with high scores indicating higher levels of social isolation.

Only child reports were analyzed.

Stigma by association was measured using 10-items from the Brief Stigma-by-Association Scale. The scale measures experiences and consequences of associated stigma, on a 3-point scale, with 0= Not at all, 1= Sometimes and 2= All the time. The theoretical range for the scale is 0-20. Summated scores were created with higher scores indicating higher levels of stigma by association experienced by caregivers.

Only caregiver reports were analyzed.

The HIV/AIDS Stigma and Discrimination Scale was used. The 22-item scale assessed respondents about what they think about people living with HIV/AIDS. Responses were rated on a 4-point scale with 1= strongly agree, 2= agree, 3=disagree and 4=strongly disagree. The theoretical range for this scale is 22- 88, with higher scores indicating higher levels of perceived HIV-related stigma and discriminatory attitudes among caregivers.

Only caregiver reports were analyzed.

Caregiver mental health functioning was assessed using 34-items from the Brief Symptom Inventory (BSI). The scale measures symptoms of anxiety, somatization and depression. Respondents were asked to rate how they felt emotionally, on a 5-point Likert scale, with 1=Never true, 2=rarely true, 3= true sometimes, 4= true most of the time and 5=always true. The theoretical range for this scale is 34-170, with higher scores representing higher levels of caregiver mental distress.

Only caregiver reports were analyzed.

Parenting stress was measured by 33 items from the Parenting Stress Index (PSI). The 33-item scale assesses symptoms related to parental distress, difficult child, and caregiver-child dysfunctional relationships. Respondents were asked to rate their parenting stress, on a 4-point Likert scale, with 1=strongly disagree, 2=somewhat disagree, 3=somewhat agree and 4=strongly agree. The theoretical range for this scale is 33-132, with high scores indicating high levels of parenting stress.

Only caregiver reports were analyzed.

MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.

Multiple Family Group (MFG): MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.

Child HIV Shame was measured by the Shame Questionnaire. The 8-item scale is used to assess child's feelings of shame on a 3-point scale, with 0 =not true, 1 = somewhat true and 2 =very true. Summated scores were created with higher scores representing high levels of HIV-associated shame. Min/max values: 0-16. Scores at 6-months are reported.

Only child reports were analyzed.

Stigma by association (Child reports) was measured using 10-items from the Brief Stigma-by Association Scale. The scale measures experiences and consequences of associated stigma, on a 3-point scale with 0= Not at all, 1= Sometimes and 2= All the time. Summated scores were created with higher scores indicating high levels of stigma-by association. Min/max values: 0-20. Scores at 6-months are reported.

Only child reports were analyzed.

The HIV/AIDS Stigma and Discrimination Scale was used. The 22-item scale assessed respondents about what they think about people living with HIV/AIDS. Responses were rated on a 4-point scale with 1= strongly agree, 2= agree, 3=disagree and 4=strongly disagree. Min/max values: 22- 88, with higher scores indicating higher levels of perceived HIV-related stigma and discriminatory attitudes among caregivers. Scores at 6-months are reported.

Only caregiver reports were analyzed.

Stigma by association was measured using 10-items from the Brief Stigma-by-Association Scale. The scale measures experiences and consequences of associated stigma, on a 3-point scale, with 0= Not at all, 1= Sometimes and 2= All the time. Min/max values: 0-20. Summated scores were created with higher scores indicating higher levels of stigma by association experienced by caregivers. Scores at 6-months are reported.

Only caregiver reports were analyzed.

The Child Depression Inventory (CDI) was used to measure children's depressive symptoms. Respondents were asked to mark a statement that best described their feelings during the past 2 weeks. Each of the 14-items on the CDI has three response options that correspond to varying levels of symptomology for clinical depression. Min/max: 0-28, with higher scores representing high levels of depressive symptoms. Scores at 6-months are reported.

Only child reports were analyzed.

Self-concept was measured using the Tennessee Self-Concept Scale (TSCS). The 20-item scale measures children's perception of identity, self-satisfaction and other behaviors. Each item was rated on a 5-point scale: 1= always false, 2=usually false, 3=sometimes true/sometimes false, 4=usually true and 5= always true. Min/max values: 20-100. Ten items in the inverse direction were reverse coded to create summated scores, with higher scores indicating higher levels of child self-concept. Scores at 6-months are reported.

Only child reports were analyzed.

Hopelessness was measured using the Beck Hopelessness Scale (BHS). The 20-item scale measures children's hopelessness and pessimistic attitudes toward the future. Items have a "true" or "false" response coded as "1" or "0" respectively. Nine items with positive wording were reverse coded to create a summated score for the entire scale. Min/max values: 0-20, with higher scores indicating higher levels of hopelessness. Scores at 6-months are reported.

Only child reports were analyzed.

Child PTSD was measured using 31 items from the abbreviated Childhood post-traumatic Stress Reaction Index (CPTS-RI). Participants were asked about reactions people sometimes have after very bad things happen and how this was applicable to them in the past month. Responses were rated on a 5-point Likert scale, with 0= None, 1= Little (1-2 days a week), 2 = some (2-3 days a week), 3 =Much (2 days a month) and 4 =most (Almost every day). Min/max values: 0-124. Summated scores were created with higher scores indicating higher levels of child PTSD symptoms. Scores at 6-months are reported.

Only child reports were analyzed.

Child self-reported adherence was assessed using three items: 1) "In the last 30 days, on how many days did you miss at least one dose of your HIV medications (range: 0-30 days)?" 2) "In the last 30 days, how often did you take your HIV medicine in the way you were supposed to (never to always)?" and 3) "In the last 30 days, how good a job did you do at taking your HIV medicine in the way you were supposed to (very poor - excellent)"? Responses were linearized into a continuous scale ranging from 0-100, with low scores representing poor adherence and 100 representing perfect adherence. Scores at 6-months are reported.

Only child reports were analyzed.

Engagement in sexual risk behaviors was measured by asking a respondent whether they had engaged in unprotected sex, coded as "yes" or "no". Number of participants who responded "yes" at 6-months are reported.

Only child reports were analyzed.

Intentions to engage in sexual risk behaviors were assessed by asking respondents to rate how 5 sexual activity-related statements applied to them. Items were rated on a 5-point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time and 5=always. Min/max values: 5-25, with higher scores indicating high intentions to engage in sexual risk-taking behaviors. Scores at 6-months are reported.

Only child reports were analyzed.

Child-caregiver support was measured using 17 items from the Social Support Behaviors Scale (SS-BS) scale. Respondents were asked to rate the adults they live with, on a 5-point Likert scale, with 1= never, 2 = sometimes, 3=about half of the time, 4=most of the time, and 5= always. Min/max values: 17-85. Summated scores were created with high scores indicating high levels of perceived support from caregivers. Scores at 6-months are reported.

Only child reports were analyzed.

Child's quality of friendships was measured using 21-items from the Friendship Qualities Scale. This multidimensional measurement scale assesses the quality of children's relationships with their best friends via several aspects, including closeness, help, safety and closeness. Respondents were asked to rate how each statement applied to them. Responses were rated on a 5- point Likert scale, with 1=never, 2=sometimes, 3=about half of the time, 4=most of the time, and 5= always. Min/max values: 21-105, with high scores indicating high quality friendship levels. Scores at 6-months are reported.

Only child reports were analyzed.

Child loneliness was assessed using the UCLA Loneliness Scale. The 20-item scale measures one's subjective feelings of loneliness as well as feelings of social isolation. Responses were rated on 4-point Likert scale with 3= I often feel this way, 2= I sometimes feel this way, 1 = I rarely feel this way, and 0=I never feel this way. Min/max values: 0-60, with high scores indicating higher levels of social isolation. Scores at 6-months are reported.

Only child reports were analyzed.

Caregiver mental health functioning was assessed using 34-items from the Brief Symptom Inventory (BSI). The scale measures symptoms of anxiety, somatization and depression. Respondents were asked to rate how they felt emotionally, on a 5-point Likert scale, with 1=Never true, 2=rarely true, 3= true sometimes, 4= true most of the time and 5=always true. Min/max values: 34-170, with higher scores representing higher levels of caregiver mental distress. Scores at 6-months are reported.

Only caregiver reports were analyzed.

Parenting stress was measured by 33 items from the Parenting Stress Index (PSI). The 33-item scale assesses symptoms related to parental distress, difficult child, and caregiver-child dysfunctional relationships. Respondents were asked to rate their parenting stress, on a 4-point Likert scale, with 1=strongly disagree, 2=somewhat disagree, 3=somewhat agree and 4=strongly agree. The theoretical range for this scale is 33-132, with high scores indicating high levels of parenting stress. Score at 6-months are reported.

Only caregiver reports were analyzed.

Group Cognitive Behavioral Therapy (G-CBT): G-CBT consists of 10-session for HIV/AIDS-associated stigma, utilizing core components of CBT, including psychoeducation, cognitive restructuring, and skill-building to increase adaptive coping mechanisms.

Multiple Family Group (MFG): MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.

Usual care consists of the traditional clinic intervention that focuses on testing services, ART treatment, and information about disease management.

Group Cognitive Behavioral Therapy (G-CBT): G-CBT consists of 10-session for HIV/AIDS-associated stigma, utilizing core components of CBT, including psychoeducation, cognitive restructuring, and skill-building to increase adaptive coping mechanisms.

Multiple Family Group (MFG): MFG consists of 10-sessions that strengthen family relationships intended to address HIV/AIDS-associated stigma at the individual level and within families. The core components of MFG are known as 4Rs and 2S's: rules, responsibility, relationships, respectful communication, stress and social support.