Behavioral problems in perinatally HIV-infected young children with early antiretroviral therapy and HIV-exposed uninfected young children: prevalence and associated factors

ABSTRACT

Although behavioral problems have been observed in children and adolescents with perinatally-acquired HIV infection (PHIV), behavioral information regarding younger PHIV children are scarce. This study aims to identify behavioral problems in PHIV and HIV-exposed uninfected (HEU) children and to evaluate factors associated with such problems. A prospective study of PHIV and HEU young children was conducted. Behavioral problems were assessed with the Child Behavior Checklist (CBCL) at baseline and 12 months later among children aged 18–60 months old. The Patient Health Questionnaire-9 and the Parenting Styles & Dimensions Questionnaire identified primary caregivers’ symptoms of depression and parenting styles, respectively, at both visits. Chi-squared analyses were used to compare the prevalence of behavioral problems between groups. Factors associated with behavioral problems were analyzed by logistic regression. From 2016 to 2017, 121 children (41 PHIV and 80 HEU) were assessed with no significant differences in prevalence of Total, Internalizing, Externalizing, and Syndrome scales problems between PHIV and HEU at both visits (p > 0.5). Primary caregivers’ depression and lower education in addition to authoritarian and permissive parenting styles were significantly related to child behavioral problems. Family-centered care for families affected by HIV, including positive parenting promotion, mental health care, and education are warranted.

KEYWORDS:

• Perinatally HIV infected children
• HIV exposed uninfected children
• behavioral problems
• depression
• parenting style

Acknowledgements

We are indebted to the participating families and children for their time and effort. The content is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. Army or the Department of Defense or the National Institutes of Health.

Disclosure statement

JA has received honoraria for participating in advisory meetings for AbbVie, Roche, Gilead, Merck and ViiV Healthcare. PT and NJ have received partial research support from Biogen, Inc. (Boston, USA) on topics unrelated to the research in this manuscript. The other authors declare that they have no conflicts of interest.

ORCID

Weerasak Chonchaiya http://orcid.org/0000-0002-0223-9969

Jintanat Ananworanich http://orcid.org/0000-0003-1369-3224

Additional information

Funding

Funding for this project was made possible in part by a CIPHER grant from the International AIDS Society 2016, a grant from amfAR through the National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907), and the 100th Chulalongkorn University Fund for Doctoral Scholarship. PT and NJ are also supported in part by U.S. National Institutes of Health grants (U54 EB020403 and P41 EB015922).