Detained adolescent females' multiple mental health and adjustment problem outcomes in young adulthood.

BACKGROUND: Although prior studies have shown that detained females are marked by significant adverse circumstances, little is known about their adult outcomes. METHOD: Prospective follow-up study of 184 (80.4% of original sample of 229) detained adolescent females who were reassessed 4.5 (SD=0.6) years later in young adulthood (mean age=20.0, SD=1.4) on mental health and adjustment outcomes. Associations between these outcomes and detained females' behavior problems and offense history were examined. RESULTS: In the total sample, 59.0% had one or more mental health problems at follow-up, whereas 96.2% were facing at least one adjustment problem. Subjects with a personality disorder (PD) reported more adjustment problems compared to subjects without PD. Mental health and adjustment problems in young adulthood were predicted by detained adolescent females' behavior problems and offense history. CONCLUSION: Detained adolescent females suffered from multiple mental health and adjustment problems in young adulthood. Females who developed PD were most impaired. Results of this study underline the compelling need for continued and gender-specific interventions. The identification of predictors during detention for poor adult outcomes can serve as targets for intervention.

The impact of counselling on HIV-infected women in Zimbabwe.

The objective of this study was to examine the impact of counselling provided for HIV-infected women in Zimbabwe. Qualitative research was used for data collection. In total, 44 women were heard; most were members of an HIV support group. Doctors and nurses play an important role in the first counselling session, because tests to diagnose HIV-infection are done in the hospital. Interviewed women mention slow disclosure of status as the most comforting way to hear the news. The HIV-infected women experience strong emotions directly after diagnosis. Counselling at this moment is of major importance to reduce fear and can prevent suicide. Women should be prevented from discovering their status on their own. Counselling given once is found not to be effective. First, if only one counselling session is given, the women may not hear or remember all that is said. Second, in case of depression, access to counselling is important and it appears that periods of depression return frequently. Support groups play an important role in providing this continuous counselling. Another advantage of the counselling provided by HIV-positive women of a support group is that the counsellors function as examples.

PIP: In sub-Saharan African countries where women are the fastest growing HIV-infected group, counseling represents an important strategy for optimizing the way women cope with their disease. Such counseling can provide family members with appropriate information, facilitate honest communication within the woman's support system, overcome stigmatization and social isolation, address the strong emotions associated with the HIV diagnosis, and help women cope with issues such as the potential for abandonment and concerns about their children's futures. The quality and impact of a counseling program for HIV-infected women in Mutare, Zimbabwe, affiliated with Family AIDS Caring Trust (FACT), were assessed through in-depth interviews and focus group discussions with 44 HIV-positive women. Respondents cited the importance of comforting support from counselors, especially when the HIV diagnosis was revealed, and advice about ways to maintain optimal health and functioning. They further indicated counseling should be continuous, given the complexity of the psychological aspects of HIV and the tendency for information conveyed in a single session not to be retained. Since most women did not inform relatives of their HIV status, support groups were important for overcoming isolation and sharing feelings and experiences. Newly diagnosed women were inspired by exposure to HIV-positive group leaders who were living a satisfying life. The FACT program stresses the concept of positive living, with an emphasis on living with AIDS rather than dying. The positive impact of HIV counseling programs documented in this study suggests a need for the health care system or nongovernmental organizations to organize AIDS support groups in areas where they do not exist, and to provide professional support to enable the groups to function appropriately and with community support.