Children and Adolescents Living with HIV and AIDS: A Review

Abstract

Worldwide, more than one million children are infected with human immunodeficiency virus (HIV) and in the United States it has become the sixth leading cause of death among 15-24-year-olds. Despite the trend of increasing rates of infection, advances in therapies have led to survival past 5 years of age for more than 65% of infected children. This global health threat will therefore continue to have a significant impact on child and adolescent psychiatry and psychology. This paper reviews current studies and reports on the consequences of the acquired immunodeficiency syndrome (AIDS) epidemic in the psychiatric care and development of children and adolescents infected by HIV. From a search of all the English-language-based literature on pediatric AIDS, 140 studies are reviewed which address HIV infection and its psychological and social implications. Several topics of mental health significance are examined: (1) the epidemiology of HIV, (2) neurocognitive development among those infected, (3) psychological impact of infection, and (4) the family and social context of HIV. The transition of HIV from an acute, lethal disease to a subacute, chronic disease has enormous implications for the neurocognitive and psychosocial development of children and families. As children and adolescents infected with HIV continue to live longer, normal developmental milestones and educational needs will take on new significance. Many children will continue to be adversely impacted by non-HIV factors such as poverty, inadequate medical services, and a lack of social support. This review outlines recent developments that hold promise to effectively reduce the treatment burden on the infected, their families, and health care providers and to decrease the incidence of transmission to the uninfected.

Paediatric HIV/AIDS disclosure: towards a developmental and process-oriented approach

“…Caregivers and healthcare workers are, therefore, presented with an array of challenges around disclosure, including deciding on what is in the child's best interest and when and how information about his/ her HIV status will be shared with him/her (Brown et al, 2000).…”

Positive futures: a qualitative study on the needs of adolescents on antiretroviral therapy in South Africa

“…Perinatally infected children are stunted, and go through puberty later than their peers (Buchacz et al, 2003;de Martino et al, 2001). The virus causes neurocognitive delay (Abubakar, Van Baar, Van de Vijver, Holding, & Newton, 2008) and is associated with behavioural issues, and a high prevalence of mental illness (Brown, Lourie, & Pao, 2000;Scharko, 2006). HIV is a disease of the family, and many adolescents are parentless and lack support structures (Ferrand et al, 2007a;Ferrand, Miller, & Jungmann, 2007b).…”

Coping and psychological adjustment in adolescents with vertically acquired HIV

“…They recognize disease/disability factors (such as type of illness, severity, and medication adherence), functional dependence, and psychosocial stressors as typical risk parameters. Children with vertically acquired HIV (infected through their mother during pregnancy, birth or breastfeeding) may face a range of such factors including compromised health for themselves and within the family, multiple bereavements, and stigma (Brown, Lourie, & Pao, 2000). Varni and Wallander (1988) state that intrapersonal factors such as temperament, socio-ecological factors (e.g., social support, family environment), and stress processing factors (e.g., coping resources and cognitive appraisal) are resistance parameters.…”