Purpose HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. Methods We compared younger (18–24 year-olds) and older (≥25 year-olds) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test, and the Edinburgh Postnatal Depression Scale (EPDS). Results Among 625 women initiating ART, 16% reported risky alcohol use, and 21% alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37% of 18–21 year-olds vs. 20% of 22–24 year-olds reported alcohol-related harm (p=0.02). Overall, 11% of women had EPDS scores suggesting probable depression, and 6% reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11% in younger and 4% in older women (p=0.003). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Conclusions Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma may be a moderating factor. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population.

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us-map.html (Accessed March 20, 2023). § Among mpox-associated deaths (38), data on gender identity was available for 28 (73.7%) decedents. For 10 (26.3%) persons for whom self-reported gender was missing, sex assigned at birth was substituted for gender identity. ¶ Case counts include those who received a positive test result for either Monkeypox virus or orthopoxvirus. ** https://www.cdc.gov/nndss/index.html (Accessed March 20, 2023).

Objective To describe physical activity in South African children with and without HIV. Study design Study measurements were obtained in 218 children with perinatal HIV and 180 children without HIV aged 5–10 years in a study conducted in Johannesburg, South Africa. Weight-for-age (WAZ) and height-for-age (HAZ) Z-scores, and frequency and duration of moderate and vigorous physical activity, and sedentary behavior, were obtained. Measures were compared between children with and without HIV. Results WAZ and HAZ were significantly lower for children with HIV compared with those without HIV. Among children who attended school, less children with HIV participated in physical education (41 vs. 64%, p=0.0003) and organized after-school sports (38 vs. 64%, p<0.001) than children without HIV. The proportion of children in both groups meeting World Health Organization recommendations for physical activity was similar (84% overall). However, girls with HIV spent less time in vigorous physical activity than girls without HIV (420 vs. 780 minutes/week, p=0.001). This difference remained significant even when girls with medical conditions with potential to limit physical activity were excluded, and after adjusting for age. Time spent in sedentary behaviors did not differ significantly between the groups. Conclusion Although children with HIV with well-controlled disease after initiating antiretroviral therapy early in life achieve high levels of physical activity, vigorous physical activity is lower in girls with HIV than in healthy controls. This may reflect lower participation in school-based physical education and organized after-school physical activity.