Children Of HIV-infected Parents Research Articles

Testing the vulnerability and scar model of the relationship between self-concept, social support and anxiety symptoms among children of HIV-infected parents in China: A 3-year longitudinal study

BackgroundMental illness is a great concern among children of HIV-infected parents (COHIP), who are at their crucial stage of psychosocial development. It has been shown that self-concept (SC) and social support (SS) are important correlates of anxiety symptoms (AS), however, nature of the causality remained unclear. MethodsA 3-year longitudinal study was conducted in rural Central China, where many people were infected with HIV through unhygienic blood donation. A total of 195 COHIP (mean age: 12.6 years, 49.2% male) completed the baseline assessment and were followed for three years. Cross-lagged structural equation modeling analyses were used to test competing theoretical models: vulnerability model (low SC/SS contributes to AS), scar model (AS erodes SC/SS) and reciprocity model (low SC/SS and AS predict each other). ResultsAt each wave, 104 (53.3%) and 67 (41.6%) participants presented with anxiety disorders respectively. Nested-model comparison supported the superiority of scar models wherein AS significantly predicted subsequent low SC (β=-0.24, p=0.013) and SS (β=-0.31, p= 0.033), controlling for synchronous and autoregressive effects of all measures. The most parsimonious multivariate model that included significant relations was finally identified with a good model fit. LimitationsFindings might be subject to reporting bias; and could not inform the temporal relationship between SC and SS. ConclusionPrevalence of anxiety was high among Chinese COHIP. The present study provides empirical evidence for scarring effects of AS; thus, highlighted the importance of identifying and treating COHIP's anxiety to mitigate long-term negative impacts on their psychosocial development.

Tuberculosis in children of HIV-infected parents

Context: Tuberculosis (TB) in children of human immunodeficiency virus (HIV) infected parents is of concern.Aims: To study the proportion of children of HIV-infected parents who suffered from TB and to study some of the associated risk factors.Settings and Design: Cross-sectional study design.Materials and Methods: Ethical approval and informed consent were taken. A total of 385 children of HIV-infected parents were studied for TB.Statistical Analysis Used: Proportion, Chi-square test.Results: In the study, it was found that there were 191 (49.6%) HIV-positive children, 136 (35.6%) HIV negative children and in 58 (14.8%) children, the HIV status was unknown. 53 (13.8%) out of 385 children had suffered from TB. Among these 50 children were HIV positive and three children were HIV negative.Conclusions: The only significant risk factor for TB in children of HIV-infected parents was HIV infection in children. Therefore, it is recommended that the HIV positive parents should be counseled to get their children tested at an integrated counseling and testing center because it was found that 15% of children had unknown HIV status. Once it is known that the child has HIV infection, effective measures should be taken to prevent TB since they are significantly at an increased risk of TB.

A model of associative stigma on depression and anxiety among children of HIV-infected parents in China.

Human immunodeficiency virus (HIV) carries a high level of stigma to the HIV-infected individuals and their family members. Children of HIV-infected parents in China are particularly affected. The present study examined the relationship between associative stigma, self-esteem, optimism, anxiety and depression among 195 children of HIV-infected parents in rural China. Findings showed that more than one-third (35.4 %) of the participants scored higher than cut-off for depression; and 23.6-67.7 % of them scored higher than cut-off for different types of anxiety disorders. Structural equation modelling revealed that associative stigma had a significant negative relationship on self-esteem and optimism, which were associated with higher levels of depression and anxiety. The indirect effects of associative stigma on depression and anxiety were significant. The overall model showed a satisfactory fit. Findings suggest that associative stigma has a significant negative impact on mental health of children affected by HIV. Interventions to reduce their associative stigma are warranted.

Fears about HIV transmission in families with an HIV-infected parent: a qualitative analysis.

Children of HIV-infected parents may be affected by their parents' disease even if not infected themselves. Because of advances in HIV treatment that have reduced the risk for vertical HIV transmission from mother to child, more HIV-infected adults are having children. Few studies have examined whether families with an HIV-infected parent experience fears about transmission to children and how they address such fears. In this article, we describe transmission-related fears in families with an HIV-infected parent. We used semistructured qualitative interviews, conducted in person from March 2004 to March 2005, with 33 HIV-infected parents, 27 minor children who were 9 to 17 years of age, 19 adult children, and 15 caregivers (adult family members or friends who helped care for the children and/or parents) to investigate their fears about HIV transmission. The parents are a subset from the HIV Cost and Services Utilization Study, a study of people in care for HIV throughout the United States. We analyzed the interview transcripts for themes related to transmission fears. In many of the families, participants identified >or=1 HIV transmission-related fear. Themes included specific fears related to blood contact, bathroom items, kissing/hugging, and food. Families addressed their fears by educating children about modes of HIV transmission and establishing rules or taking precautions to reduce the risk for HIV transmission in the household. HIV-infected parents were also concerned about catching opportunistic infections from a sick child. Many of the fears experienced by HIV-infected parents and their children were based on misconceptions about modes of HIV transmission. Pediatricians and others who treat these children may be able to offer counseling to allay fears that family members have about household transmission of HIV.

Education and Nutritional Status of Orphans and Children of Hiv–Infected Parents in Kenya

We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate logistic regression. Results indicate that orphans, fostered children, and children of HIV-infected parents are significantly less likely to attend school than non-orphaned/non-fostered children of HIV-negative parents. Children of HIV-infected parents are more likely to be underweight and wasted, and less likely to receive medical care for ARI and diarrhea. Children of HIV-negative single mothers are also disadvantaged on most indicators. The findings highlight the need to expand child welfare programs to include not only orphans but also fostered children, children of single mothers, and children of HIV-infected parents, who tend to be equally, if not more, disadvantaged.

Children of HIV-Infected Parents: Custody Status in a Nationally Representative Sample

The purpose of this work was to determine the rates and predictors of custody status for children of HIV-infected parents. Data came from interviews of 538 parents with 1017 children (0-17 years old) from a nationally representative sample of HIV-infected adults receiving health care in the United States. Outcomes were collected at 2 survey waves and included child custody status and who, other than the HIV-infected parent, had custody of the child. Child custody status was categorized as (1) in custody of HIV-infected parent at both survey waves, (2) infected parent had custody at first survey wave but not second survey wave, (3) not in custody of infected parent at either survey wave, and (4) infected parent gained custody between survey waves. Potential custodians included (1) other biological parent, (2) state, foster, or adoptive parent, (3) grandparent, and (4) relative, friend, nonbiological parent, or other. Multinomial logistic regression modeled both outcomes. Forty-seven percent of the children were in the custody of their HIV-infected parent at both survey waves, 4% were in the parent's custody at the first but not second survey wave, 42% were not in custody at either survey wave, and the parent of 7% gained custody between survey waves. Parents cited drug use (62%) and financial hardship (27%) as reasons for losing custody. Children of HIV-infected fathers, older parents, parents living without other adults, parents with low CD4 counts, drug-using parents, and parents with > or = 1 hospital stay were less likely to be in their parent's custody at either survey wave. More than half of the children were not in custody of their HIV-infected parent at some time during the study period. Pediatricians and others taking care of children with HIV-infected parents may be able to offer counseling or referrals to assist parents with child custody issues.

The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai, Uganda

There are limited empirical data on the prevalence and incidence of orphanhood due to parental HIV infection. To assess the prevalence and incidence of orphanhood, and the population attributable fraction (PAF) of incident orphanhood associated with parental HIV infection, in a rural population with a 14.8% adult HIV prevalence. The data are derived from a community cohort in Rakai District, Uganda. Census data were collected on all resident members in 10,657 households, including survival of parents of resident children in 1996/1997. Consenting adults were interviewed, provided blood for HIV testing, and were followed up 10 months later to determine parental death and incident orphanhood. The incidence rate ratio (IRR) of orphanhood associated with parental HIV-infection was estimated by Poisson multivariate regression. A total of 22,712 children aged 0-14 years were enumerated in 1996/1997. The overall prevalence of orphanhood was higher among children of HIV-infected parents (22.7%) compared with children of uninfected parents, 7.9%. The annual incidence of orphanhood was 8.2% if at least one parent was HIV positive, and 0.5% if both parents were HIV negative (adjusted IRR = 18.93). Older age of children, and older maternal age were significantly associated with an increased risk of orphanhood. The PAF of incident orphanhood due to parental HIV infection was 37.3%, and was highest among younger children (adjusted PAF = 50.6% for 0-4 year olds), and children with younger mothers aged < 25 years (adjusted PAF = 75.7%). Parental HIV infection markedly increased the incidence of orphanhood, especially among younger children and the children of younger mothers.