HIV and child mental health: a case-control study in Rwanda
Betancourt, T.; Scorza, P.; Kanyanganzi, F.; Fawzi, M.C.S.; Sezibera, V.; Cyamatare, F.; Beardslee, W.; Stulac, S.; Bizimana, J.I.; Stevenson, A.; Kayiteshonga, Y.
Pediatrics 134(2): E464-E472
2014
ISSN/ISBN: 1098-4275 PMID: 25049342 DOI: 10.1542/peds.2013-2734Document Number: 623854
The global HIV/AIDS response has advanced in addressing the health and well-being of HIV-positive children. Although attention has been paid to children orphaned by parental AIDS, children who live with HIV-positive caregivers have received less attention. This study compares mental health problems and risk and protective factors in HIV-positive, HIV-affected (due to caregiver HIV), and HIV-unaffected children in Rwanda. A case-control design assessed mental health, risk, and protective factors among 683 children aged 10 to 17 years at different levels of HIV exposure. A stratified random sampling strategy based on electronic medical records identified all known HIV-positive children in this age range in 2 districts in Rwanda. Lists of all same-age children in villages with an HIV-positive child were then collected and split by HIV status (HIV-positive, HIV-affected, and HIV-unaffected). One child was randomly sampled from the latter 2 groups to compare with each HIV-positive child per village. HIV-affected and HIV-positive children demonstrated higher levels of depression, anxiety, conduct problems, and functional impairment compared with HIV-unaffected children. HIV-affected children had significantly higher odds of depression (1.68: 95% confidence interval . The mental health of HIV-affected children requires policy and programmatic responses comparable to HIV-positive children.