DESCRIPTION (provided by applicant): The incidence of HIV infection is increasing among heterosexual women of childbearing age in the United States. Advances in the treatment of HIV have resulted in longer lifespans for those with the virus, as well as reductions in the incidence of vertical transmission. Women living with HIV report that their greatest source of stress is combining their role as mother with the medical and psychological demands of coping with a chronic, life-threatening condition. Social isolation, depression, and a lack of confidence in parenting skills are common, and significantly affect women?s quality of life. Despite this evolution in the epidemic, interventions to assist HIV+ mothers with the demands of the combined parent and patient roles are rare. Such interventions are urgently needed by this highly burdened yet underserved population. The primary objective of the proposed 5-year project is to conduct a randomized clinical trial to evaluate the efficacy of a 6-week, theory-based, behavioral intervention to enhance positive parenting skills among HIV+ mothers. We will recruit 240 participants from among women receiving services at the UAB 1917 Clinic, the Children?s Hospital Family Clinic, AIDS Alabama, or AIDS in Minorities. Participants will be randomized either to an attention control condition or to a theory-based skills training condition that systematically addresses specific psychosocial issues associated with parenting as an HIV+ mother. The primary outcome measure to evaluate parenting outcomes will be use of positive parenting behaviors, measured by the Parent Practices Scale. The secondary outcome measures will be physical and mental maternal health status, measured by the MOS-HIV, and children?s behavior, measured by the CBCL. Additional measures collected will include parenting self-efficacy, overall parenting stress, children?s reports of parental behaviors, and behavioral observations of parent-child interactions. Depressive symptoms, hopelessness, household composition, child temperament and serostatus, and parents? social support will also be assessed to examine theoretical assumptions regarding the relationships between these constructs and parenting. Outcome measures will be collected at baseline and at weeks 6, 18, and 30. This application brings together a strong group of investigators with a history of individual and collaborative research relevant to the conduct of the proposed study examining the behavioral and social issues faced by HIV-affected families.