Abstract
BackgroundPerinatally acquired HIV-infected (PHIV+) adolescents have shown impairments in neurocognitive function and mental health problems compared with their peers. The contribution of food insecurity to such impairments has not been explored.ObjectivesThe aim of this report has been to explore the contribution of food insecurity to neurocognitive impairment and mental health problems in adolescents with perinatally-acquired HIV infection.MethodA total of 248 PHIV+ adolescents and healthy controls aged between 9 and 12 years completed a neuropsychological battery, the Childhood Behaviour Checklist (CBCL) and the Becks Youth Inventory. Head circumference, body mass index (BMI), height for age (HAZ), Tanner pubertal staging, albumin, haemoglobin, CD4 and viral loads were also measured. Participants’ caregivers were interviewed about their mental health and household food security. T-tests were used to assess for differences in food secure and food insecure households.ResultsCaregivers of PHIV+ adolescents reported higher levels of depressive symptoms and household food insecurity. Increased food insecurity was associated with more behavioural problems in adolescents, as well as lower haemoglobin and albumin levels, faster processing speed and increased Tanner staging in boys. Body mass index and HAZ were not affected by food insecurity.ConclusionThese findings suggest that household food insecurity is associated with some altered behavioural, physical and physiological outcomes, which could complicate and compound the existing difficulties in PHIV+ households.
Highlights
Adolescents with perinatally acquired HIV infection (PHIV+) have worse outcomes in general cognitive development and mental health compared with age-matched HIV-negative peers,[1,2,3,4,5] with the socioeconomic status as a potential cofounder.[6]
This is a cross-sectional analysis of enrolment data from a neuropsychiatric sub-study of the Cape Town Adolescent Antiretroviral Cohort (CTAAC), a study of PHIV+ adolescents on antiretroviral therapy (ART) in a large city in South Africa
HIV-negative healthy controls (HCs) were frequency matched with PHIV+ participants on age, sex and ethnicity
Summary
Adolescents with perinatally acquired HIV infection (PHIV+) have worse outcomes in general cognitive development and mental health compared with age-matched HIV-negative peers,[1,2,3,4,5] with the socioeconomic status as a potential cofounder.[6]. Cognitive and behavioural problems in youth are aggravated in situations of poverty.[9] Food insecurity has been associated with increased cognitive and behavioural problems in children and adolescents. Both externalising and internalising subscales of the Childhood Behaviour Checklist (CBCL),[10,11] as well as behaviour reports from teachers,[12] have been associated with food insecurity. Acquired HIV-infected (PHIV+) adolescents have shown impairments in neurocognitive function and mental health problems compared with their peers. The contribution of food insecurity to such impairments has not been explored
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