Interventions Addressing Neurodevelopmental Delay in Young Children Infected With and Exposed to HIV: A Scoping Review

Abstract

Background: Neurodevelopmental delays have been documented in children living with and infected by the human immunodeficiency virus (HIV). Early childhood stimulation programs can positively impact neurodevelopmental outcomes and have a far-reaching effect beyond childhood. Objective: To conduct a scoping review mapping evidence describing interventions aimed at mitigating or preventing neurodevelopmental delays resulting from exposure to or infection with HIV in preschool children. Methods: Electronic databases of PubMed, PsycINFO, CINAHL Plus, Google Scholar, and the Cochrane Library, reference lists of identified articles, and gray literature were searched. Title and abstract and full-text reviews were conducted independently by 2 reviewers. Study location, design, sample size, age of cohort, child's HIV serostatus, antiretroviral treatment availability for children or caregivers, neurodevelopmental assessment tool used, and details of the intervention and comparison groups were documented. Results: Ten studies meeting predetermined inclusion and exclusion criteria were identified. Six studies focused on training provided to the child's caregiver of which one offered an intervention focused specifically on stimulating child development through a home-based stimulation program. Four studies provided a child-directed intervention. Interventions ranged in duration from 10 days to 15 months. Intensity of the intervention varied from 3 times per day to biweekly. Interventions were aimed at children in the neonatal period throughout the preschool years. Conclusion: Many children are at risk of poor neurodevelopmental outcomes due to HIV infection. Few studies investigating interventions aimed at addressing this problem were identified. Further research into effective interventions aimed at improving childhood neurodevelopmental outcomes in the context of HIV is required.

Neurodevelopment in early treated HIV‐infected infants participating in a developmental stimulation programme compared with controls

“…Interventions aimed at improving developmental outcomes in HEI children have been employed but differ widely in their approach (Strehlau, van Aswegen, & Potterton, 2019) and effectiveness (Sherr, Croome, Bradshaw, & Parra Castaneda, 2014). Programmes aimed at improving childhood developmental outcomes have shown substantial and sustainable results (Engle et al, 2007).…”

“…Childhood HIV management programmes do not, however, uniformly emphasize developmental stimulation nor screening for developmental delays. Reported developmental interventions utilized for HIV‐infected children differ widely in their approach, duration, intensity and timing (Strehlau, van Aswegen, & Potterton, 2019). Consequently, results may not be comparable.…”

An interprofessional model of care for adolescents with perinatal HIV: A qualitative study

“…There are emerging physical challenges that PHIVA face, specifically with regard to growth failure, delayed puberty, and cardiac and lung dysfunction. 4 , 5 Numerous studies have highlighted the detrimental effects of perinatal HIV on both birth weight and developmental milestones, 6 , 7 leading to persistent growth issues that extend into adolescence. 5 An analysis of data from 8737 PHIVA found that by age 10, 39% of female PHIVA and 34% of male PHIVA experienced stunted growth.…”

Cross-Sectional Analysis of Cognitive And Functional Difficulties Among Adolescents Living With HIV In Low-Resourced Settings: Can A Simple Screening Algorithm Identify Adolescents For Support?

“…Cognitive di culties may also play a role in the complex skills needed to avoid risky behaviour, such as negotiating safety, self-con dence to avoid drug and alcohol misuse, and strategic planning and coping to navigate social challenges. However, cognitive functioning of ALHIV in Sub-Saharan Africa remains a neglected area of research and service provision (17,18). This is compounded by the limited availability of resources (both technical and nancial) required to administer comprehensive neuropsychological assessment batteries to identify functioning levels and refer to services where available.…”