Identification of psychological behaviours among children having parental HIV infection and their determinants in Myanmar: a comparative study with neighbourhood peers

ABSTRACT

Psychological impact is one of the direct and indirect consequences of HIV and AIDS on children. A national survey applying a cross-sectional comparative design was conducted among children aged 4–16 years with parental HIV infection and age-group matched neighbourhood peers without parental HIV infection to identify and compare their psychological behaviours and determinants. A multistage sampling method was used. Face-to-face interviews were conducted with parents/guardians of the children to obtain family characteristics and children’s psychological behaviours using the modified Strengths and Difficulties Questionnaire. Factor analysis identified three domains of psychological behaviours, namely social, emotional and conduct behaviours. Comparison of these behaviours was done using Chi-squared test with Rao–Scott adjustment. Determinants of these behaviours were identified using survey-weighted logistic regression adjusted for socio-demographic variables. A total of 1280 children with parental HIV infection and 1279 neighbourhood peers participated in the study. Social conditions of the two groups differed in terms of family displacement (24.6% vs. 8.9%, p < 0.001), family dispersion (12.4% vs. 3.7%, p < 0.001), and child displacement (10.3% vs. 3.5%, p < 0.001). Emotional behaviour was significantly different between the two groups (31.3% vs. 24.0%, p < 0.01) but no difference in social or conduct behaviours was evident. Children from extended families (adjusted odds ratio (AOR): 1.34, 95% CI: 1.07–1.67), females (AOR: 1.37, 95% CI: 1.07–1.75), orphans (AOR: 1.62, 95% CI: 1.29–2.05) and children who experienced family displacement (AOR: 1.38, 95% CI: 1.11–1.72) were more likely to have abnormal emotional behaviour. Children from extended families (AOR: 0.77, 95% CI: 0.62–0.97) had less chance of having abnormal conduct behaviour. In contrast, preschool (AOR: 2.73, 95% CI: 1.92–3.87) and out-of-school children (AOR: 1.47, 95% CI: 1.01–2.27) were more likely to have abnormal conduct behaviour. Development of long-term strategies for reducing the risk of behavioural problems among children with parental HIV infection is suggested.

KEYWORDS:

• Children with parental HIV
• psychological behaviour
• children affected by HIV
• neighbourhood peers
• Myanmar

Acknowledgements

This study was a part of the thesis of the first author to fulfil the requirement of the Doctoral degree on Epidemiology at Prince of Songkla University. Funding support for this study was provided by United Nations Children Fund (UNICEF) country office in Myanmar and Graduate School of Prince of Songkla University, Thailand through Discipline of Excellence Award. Our sincere gratitude is directed to Director Generals of Department of Medical Research and Department of Public Health for allowing us to conduct the study. Our great thanks are directed to Program Manager and all responsible persons from National AIDS Program (NAP), all Directors of State/Region Health Departments, National and International NGO working in the field of HIV, PLHIV network and self-help groups across the country for their kind coordination in conducting the study. We are also grateful to all the children and their guardians who participated in the study. I would like to express my sincere gratitude to Mr. Edward McNeil for statistical support and English editing in preparing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Graduate School of Prince of Songkla University, Thailand [Discipline of Excellence Award]; United Nations Children’s Fund (UNICEF) country office in Myanmar.