Introduction. In resource-limited settings where HIV disproportionately affects women, there is a need for family-centered HIV care that includes the provision of psychosocial support services. This dissertation drew on baseline interviews with HIV-positive adults who were either caregivers or first-line relatives of HIV-infected children enrolled in a family-centered HIV care and treatment program in Kinshasa, Democratic Republic of Congo (DRC). This study explored the relationships among social support, perceived stigma, and quality of life (QOL) in the adult patients. I also examined associations among caregiver education, disease stage upon enrollment, and program attrition among the pediatric patients. Finally, I considered measurement issues in adapting scales developed elsewhere to the context in DRC. Methods. Data were obtained from baseline interviews with 275 HIV-positive adults and from 780 children enrolled in a family-centered HIV care and treatment program. Results. The adult sample was 84% female and largely mothers. There was a positive association between social support and psychological status, one of six domains in the World Health Organization HIV Quality of Life measure, and a negative association between perceived stigma and psychological status. Perceived stigma moderated the relationship between social support and psychological status but did not moderate the relationship between social support and overall QOL. There was a negative association between caregiver education and pediatric HIV clinical stage at enrollment. However, children of caregivers with less education were not more likely to be deactivated from the study than children of caregivers with more education. Conclusions. Enhancing social support may be particularly important for those reporting high stigma in improving psychological status, one of six QOL domains. Though a negative association was observed between caregiver education and pediatric HIV clinical stage at enrollment, children of caregivers with less education were not more likely to be deactivated from the study than children of caregivers with more education. This may have been due, in part, to the psychosocial support services provided to patients and their caregivers. Program recommendations include examining factors associated with delayed enrollment and documenting which patients receive support services so that dose-response relationships can be considered when assessing program attrition
