Behavior and psychological functioning of young children of HIV-positive mothers in South Africa

• Published in: AIDS care Vol. 25; no. 6; pp. 721 - 725
• Main Authors: Sipsma, Heather, Eloff, Irma, Makin, Jennifer, Finestone, Michelle, Ebersohn, Liesel, Visser, Maretha J., Sikkema, Kathleen J., Allen, Charmayne A. Boeving, Ferreira, Ronél, Forsyth, Brian
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 08.05.2013; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adaptation, Psychological; Adult; AIDS/HIV; Antiretroviral drugs; Antiviral agents; Behavioural psychology; Biological and medical sciences; Child; child behavior; Child Behavior Disorders - psychology; Child, Preschool; Children; Clinical trials; Cross-sectional analysis; disclosure; Drug therapy; Emotional Intelligence; Female; HIV; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Internal-External Control; Male; Maternal & child health; maternal HIV; Medical diagnosis; Medical sciences; Mother-Child Relations - psychology; Mothers; Mothers - psychology; Multivariate analysis; Parent-child relations; psychological; Psychological factors; Psychological functioning; Self Disclosure; South Africa; Stress, Psychological; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young children; South Africa; Africa; Tshwane South Africa; Human; Social environment; Immunopathology; disclosure; psychological; Mental health; Retroviridae; AIDS; maternal HIV; Immune deficiency; Lentivirus; Infection; Virus; child behavior; Mother; Viral disease; Self disclosure; South Africa; Behavior; Human immunodeficiency virus; Child; Public health
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2013.779627

Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6-10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children.