Attention and neurodevelopment in young children who are HIV-exposed uninfected

ABSTRACT

Children HIV-exposed, uninfected (CHEU) are at risk for compromised developmental outcomes. Attention is important for behavioural, cognitive and academic skills, yet has not been thoroughly investigated compared to children HIV-unexposed uninfected (CHUU). Fifty-five CHEU and 51 CHUU children were recruited at 5.5 years of age. Measures of inattention (IA), hyperactivity/impulsivity (HI) and total scores were collected using the parent-reported ADHD-Rating-Scale-IV. Measures of intelligence, visuomotor skills, academics and adaptive functioning were obtained. Analyses of between-group differences were performed as were correlational and multiple regression models, accounting for maternal education, employment and delivery type. Few children met clinical cut-offs for probable ADHD (3.6% CHEU, 2.0% CHUU), and no group differences in measures of IA, HI and combined scores were found. CHEU scored significantly lower than CHUU on intelligence, visuomotor function, academic skills and aspects of adaptive behaviour, though within age expectations. Lower Full-Scale IQ and Processing Speed were associated with higher IA in CHEU and lower adaptive functioning with higher IA in CHUU. Across both groups, children of unemployed mothers had more HI symptoms. CHEU were not at increased risk for attention difficulties at 5.5 years of age. Maternal employment status highlights the contribution of sociodemographic factors in shaping behaviour and neurodevelopment.

KEYWORDS:

• HIV-exposed uninfected children
• attention
• hyperactivity
• behavior
• neurodevelopment
• ADHD

Acknowledgements

We would like to thank Alda Fernandes-Penney for her psychometry expertise and Cheryl Arneson for assistance in data collection. We would also like to thank Klajdi Puka, Hala Shamsi, and Ramendeep Sehra for recruitment efforts, and Georgina MacDougall and Robyn Salter for their assistance with medical chart reviews.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data may be available upon reasonable request.

Additional information

Funding

This research was supported by the RBC Foundation and the Canadian Foundation for AIDS Research (CANFAR) under grant number 024-006. Dr. Julia Young is supported by the Canadian Institutes of Health Research (HIV-176646).