Keith Maynard and Chip McLaughlin, having filed for a marriage license in the early hours of May 17, 2004, respond to the greetings of the jubilant crowd outside of Cambridge City Hall in Boston, Massachusetts. Photograph by Marilyn Humphries. Printed with permission.
Lee et al.’s article is significant, as HIV/AIDS has spread to epidemic proportions.1 Social support from family and friends is indeed an important contributor of a better quality of life among HIV-affected families and their adolescents.
However, I would like to highlight a few pertinent issues regarding the article. First and foremost, Lee et al. were only restating what is already known and did not contribute anything new to the existing literature on the significance of social support. The fact that the data they used are more than 10 years old raises concerns about the validity of certain findings, especially in the context of the enormous advancement in the field of HIV/ AIDS treatment and care.
The authors state that there is a “lack of a reliable, general, and convenient index of social support,”1(p1820) which was their own limitation as well. I believe that there would be a significant difference in the degree of depression as well as in the protective effect of social support on adolescents according to their parent’s stage of disease. Lee et al. did not provide adequate information on the effect of stage of disease. Because the authors used the Brief Symptom Inventory2 to measure the levels of depressive symptoms, it would have been more appropriate to refer to them as “depressive symptoms” rather than “depression,” which gives the impression of a diagnosis on the basis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.3
The statistical analysis and the results would have been clearer if the authors had depicted the models and provided the values. At this point we are left to take the authors’ word for the above findings without having a value for validation. Lee et al. did not give any information on the nature of social support, which would have been useful for planning and implementing intervention programs for HIV-affected families.
Lastly, it was very disappointing to see several typographical errors (pp 1820–1821) in a high-impact journal such as the American Journal of Public Health.
Acknowledgments
This work was supported by a postdoctoral fellowship from the National Institutes of Health Fogarty International Center (grant TW 005811, LB Cottler, principal investigator).
References
- 1.Lee S, Detels R, Rotheram-Borus NJ, Duan N. The effect of social support on mental and behavioral outcomes among adolescents with parents with HIV/ AIDS. Am J Public Health. 2007;97:1820–1826. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Derogatis LR. Brief Symptom Inventory: Administration, Scoring, and Procedure Manual. Minneapolis, MN: National Computer System; 1993.
- 3.Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC; American Psychiatric Association; 1994.