Jacqueline Hoare1, Nicole Phillips1, Kirsty Brittain2,3, Landon Myer2,3, Heather J Zar4,5, Dan J Stein1,6. 1. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. 2. Division of Epidemiology and Biostatistics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 3. Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 4. Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. 5. SA Medical Research Council Unit on Child and Adolescent Health, South Africa. 6. Medical Research Council Unit on Risk & Resilience in Mental Disorders, South Africa.
Abstract
BACKGROUND: The impact of HIV and antiretrovirals (ART) on long-term mental health in perinatally infected children has not been well studied in sub-Saharan Africa where HIV is most prevalent. SETTING: Cape Town, South Africa. METHODS: We investigated mental health measures, including depression, anxiety, attention-deficit hyperactivity disorder, motivation, disruptive behavior, and functioning in perinatally infected adolescents (PHIV+) stable on ART within the Cape Town Adolescent Antiretroviral Cohort. Two hundred four adolescents living with HIV (median age 10 years; mean CD4 953) and a sample of 44 uninfected adolescents were enrolled. The Beck Youth Inventories, Children's Motivation Scale, Conner's Parent's Rating Scale, and Child Behavior Checklist were administered. Among PHIV+, we explored independent associations between HIV-related stigma, recent life stressors, sociodemographic, clinical, and caregiver-related variables, and mental health measures. RESULTS: PHIV+ had poorer functional competence, self-concept and motivation, higher levels of disruptive behavior, depression and attention-deficit hyperactivity disorder symptoms and clinically significant anger and disruptive behavior. Within the PHIV+ group, the loss of both biological parents was associated with higher levels of disruptive behavior. Within the PHIV+, factors associated with mental health symptoms and poorer functioning were mostly sociodemographic factors, HIV-related stigma, and life stressors. Age of initiation of ART was associated with self-concept, and failing first-line ART with internalizing and externalizing behavior problems. CONCLUSIONS: PHIV+ are likely to face future physical and psychological health consequences related to the functional competence challenges they face if mental health care is not made a priority in the fight against HIV.
BACKGROUND: The impact of HIV and antiretrovirals (ART) on long-term mental health in perinatally infectedchildren has not been well studied in sub-Saharan Africa where HIV is most prevalent. SETTING:Cape Town, South Africa. METHODS: We investigated mental health measures, including depression, anxiety, attention-deficit hyperactivity disorder, motivation, disruptive behavior, and functioning in perinatally infected adolescents (PHIV+) stable on ART within the Cape Town Adolescent Antiretroviral Cohort. Two hundred four adolescents living with HIV (median age 10 years; mean CD4 953) and a sample of 44 uninfected adolescents were enrolled. The Beck Youth Inventories, Children's Motivation Scale, Conner's Parent's Rating Scale, and Child Behavior Checklist were administered. Among PHIV+, we explored independent associations between HIV-related stigma, recent life stressors, sociodemographic, clinical, and caregiver-related variables, and mental health measures. RESULTS: PHIV+ had poorer functional competence, self-concept and motivation, higher levels of disruptive behavior, depression and attention-deficit hyperactivity disorder symptoms and clinically significant anger and disruptive behavior. Within the PHIV+ group, the loss of both biological parents was associated with higher levels of disruptive behavior. Within the PHIV+, factors associated with mental health symptoms and poorer functioning were mostly sociodemographic factors, HIV-related stigma, and life stressors. Age of initiation of ART was associated with self-concept, and failing first-line ART with internalizing and externalizing behavior problems. CONCLUSIONS: PHIV+ are likely to face future physical and psychological health consequences related to the functional competence challenges they face if mental health care is not made a priority in the fight against HIV.
Authors: J G Rabkin; S J Ferrando; W van Gorp; R Rieppi; M McElhiney; M Sewell Journal: J Neuropsychiatry Clin Neurosci Date: 2000 Impact factor: 2.198
Authors: Claude A Mellins; Katherine S Elkington; Cheng-Shiun Leu; E Karina Santamaria; Curtis Dolezal; Andrew Wiznia; Mahrukh Bamji; Mary M Mckay; Elaine J Abrams Journal: AIDS Care Date: 2012-04-23
Authors: Stella E Panos; A C Del Re; April D Thames; Timothy J Arentsen; Sapna M Patel; Steven A Castellon; Elyse J Singer; Charles H Hinkin Journal: AIDS Care Date: 2013-06-11
Authors: Maria Molinaro; Heather R Adams; Sylvia Mwanza-Kabaghe; Esau G Mbewe; Pelekelo P Kabundula; Milimo Mweemba; Gretchen L Birbeck; David R Bearden Journal: AIDS Behav Date: 2021-02-25
Authors: Annette H Sohn; Pagakrong Lumbiganon; Nia Kurniati; Keswadee Lapphra; Matthew Law; Viet C Do; Lam Van Nguyen; Khanh H Truong; Dewi K Wati; Pradthana Ounchanum; Thanyawee Puthanakit; Tavitiya Sudjaritruk; Penh S Ly; Nik K N Yusoff; Sieu M Fong; Thahira J Mohamed; Revathy Nallusamy; Nagalingaswaran Kumarasamy; Azar Kariminia Journal: AIDS Date: 2020-08-01 Impact factor: 4.632
Authors: A S Dessauvagie; A Jörns-Presentati; A-K Napp; D J Stein; D Jonker; E Breet; W Charles; R L Swart; M Lahti; S Suliman; R Jansen; L L van den Heuvel; S Seedat; G Groen Journal: Glob Ment Health (Camb) Date: 2020-10-26
Authors: Sarah Heany; Nicole Phillips; Landon Myer; Heather Zar; Dan Stein; Jacqueline Hoare Journal: South Afr J HIV Med Date: 2021-12-15 Impact factor: 2.744
Authors: Ezra K Too; Amina Abubakar; Carophine Nasambu; Hans M Koot; Pim Cuijpers; Charles Rjc Newton; Moses K Nyongesa Journal: J Int AIDS Soc Date: 2021-06 Impact factor: 6.707
Authors: Moses K Nyongesa; Paul Mwangi; Michael Kinuthia; Amin S Hassan; Hans M Koot; Pim Cuijpers; Charles R J C Newton; Amina Abubakar Journal: BMC Psychiatry Date: 2021-02-10 Impact factor: 3.630