July 21, 2014
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Mental health of children affected by HIV comparable to children with HIV

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Children affected by HIV experience anxiety and depression similar to children with HIV, which researchers said is indicates a need for policy and programmatic responses, according to study findings in Pediatrics.

Theresa Betancourt, ScD, MA, of Harvard School of Public Health in Boston, and colleagues assessed mental health, risk and protective factors among 683 children, aged 10 to 17 years, with different levels of HIV exposure. Children were assigned to groups depending on HIV exposure: HIV-positive (n=218); HIV-affected (n=228); and HIV-unaffected (n=237). Children who had a caregiver with HIV or had a parent die as a result of AIDS complications were considered HIV-affected. The study was conducted in two districts in Rwanda between March 2012 and December 2012.

Across all mental health variables, HIV-affected children had significantly higher levels of difficulties compared with children unaffected by HIV. Further, levels of mental health difficulties among HIV-affected children were not statistically different from those among children with HIV.

When adjusting for gender, age, education, primary caregiver and socioeconomic status, HIV-affected children had higher odds of having clinical levels of depression (OR=1.68; 95% CI, 1.15-2.44); anxiety and internalizing issues (OR=1.77; 95% CI, 1.14-2.75); and conduct disorder (OR=1.59; 95% CI, 1.04-2.45) compared with children unaffected by HIV. Odds ratios for mental health issues were not significantly different between children with HIV and children affected by HIV.

HIV-affected children and children with HIV reported experiencing higher levels of stigma than children who were unaffected by HIV. However, HIV-affected children reported experiencing higher levels of daily hardships and harsh punishment than children unaffected by HIV.

Children with HIV and affected by HIV were more likely to have experienced the death of a caregiver compared with children unaffected by HIV. Children with HIV were significantly less likely to have their mother as their caregiver than children in the other two groups.

“Our findings indicate that even in an increasingly supportive context in Rwanda, HIV-affected youth contend with serious threats to their mental health, comparable to HIV-positive youth. As services for HIV-positive children improve globally, additional awareness is needed for children who live with HIV-positive caregivers, along with ongoing attention to children orphaned by AIDS,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.