Children and adolescents living with HIV positive parents: Emotional and behavioural problems

Abstract

This study explores the emotional and behavioural problems in children living with an HIV-positive parent, and identifies specific high-risk and protective factors for their psychological well-being. Data were collected on 718 parents living with HIV and on 1136 HIV-affected children in a European multi-centre study (EUROSUPPORT IV) adopting a cross-sectional and retrospective study design. Sociodemographic characteristics, HIV-related stressors, variables relating to caregiving and outcome variables relating to family functioning and children's symptoms were assessed using a self-reported questionnaire. Results indicated a low level of parental HIV disclosure to children, and an elevated level of behavioural symptoms in HIV-affected children as reported by parents. Children had experienced a high degree of distressing life events. In multivariate analysis, perceived healthy family functioning emerged as protective for a low degree of behavioural symptoms in children and adolescents. The results call for a shift towards family-centred service delivery in HIV care and counselling. Service implications are discussed in the light of increasing numbers of women and couples living with HIV who become parents and need tailored support in facing the challenges of being a caregiver living with HIV.

Keywords:

• Behavioural problems
• emotional problems
• coping
• families living with HIV
• family functioning
• HIV-affected adolescents
• HIV-affected children
• parents with HIV
• psychosocial support

Acknowledgements

The authors would like to thank all respondents who filled in the questionnaire. The investigators of the participating centres were (authors not included): Ann-Sofie Åsander (Karolinska Institute, Stockholm), D. Asboe (St. Steven's Centre, London), L. Caldeira (Hospital Santa Maria, Lisbon), N. Dedes (Synthesis, Athens), C. Giaquinto (University of Padova, Padua), F. Goebel (Ludwig-Maximilian University, Munich), D. Gredig and S. Nideroest (University of Aargau, Aargau), G. Koitz and N. Vetter (Otto Wagner Spital, Vienna), U. Sonnenberg-Schwan (German AIDS Society, Munich), C. Uberti-Foppa (HSR Ospedale, Milan), B. Vandercam (Cliniques Universitaires St-Luc, Brussels), J. K. Vermunt (University of Tilburg, Tilburg) and E. Wilkins (North Manchester Health Care NHS Trust, Manchester).This study was made possible with a grant from the European Commission, SANCO/Public Health, grant agreement no. SPC2002418.