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Children of HIV-positive drug-using parents
Daniel J Pilowsky1, Patricia A Zybert, Pei-Wen Hsieh
1Mailman School of Public Health at Columbia University, USA. dp14@columbia.edu
Insights
Parental HIV infection in injection drug users (IDUs) did not directly impact children
Area of Science:
- Pediatric Psychology
- Public Health
- Infectious Diseases
Background:
- Children of injection drug users (IDUs) face unique challenges.
- Understanding the impact of parental human immunodeficiency virus (HIV) status on child psychopathology is crucial.
Purpose of the Study:
- To examine associations between parental HIV status in IDUs and their children's psychopathology and social functioning.
- To investigate the influence of apparent vs. inapparent HIV infection and parental depression on child outcomes.
Main Methods:
- Longitudinal study of 61 primarily African-American IDU parents and 79 children (ages 6-11).
- Parental HIV status, HIV-related symptoms, disclosure, and depression were assessed.
- Child outcomes measured using the Child Behavior Checklist and the Schedule for Affective Disorders and Schizophrenia for School-Age Children.
Main Results:
- Children of IDU parents showed high rates of psychopathology.
- Parental HIV infection itself did not impact children's outcomes.
- Apparent parental HIV infection was linked to an eightfold increase in disruptive behavior disorders (OR 7.80).
- Parental depression was associated with a threefold increase in disruptive behavior disorders (OR 3.49).
Conclusions:
- Parental HIV status alone does not differentially affect children's psychopathology.
- Apparent parental HIV infection may be associated with increased externalizing symptoms and disruptive behavior disorders in children.
- Parental depression is a significant factor in children's behavioral issues.
Objective:
Associations between human immunodeficiency virus (HIV) status of injection drug users (IDUs) and their children's psychopathology and social functioning were examined.
Method:
Parents (N = 61) were drawn from an ongoing longitudinal study of inner city, primarily African-American IDUs. Children (N = 79) were 6 to 11 years of age, currently living with the IDU parent. Parental variables included HIV status, apparent and inapparent HIV infection (with HIV-related medical symptoms and/or disclosure of parental HIV status to children; with neither medical symptoms nor disclosure, respectively), presence of HIV-related medical symptoms, HIV disclosure status to each child, and depression as ascertained by the Center for Epidemiologic Studies-Depression. Children's outcomes (competencies, psychiatric symptoms, and disorders) were assessed with the Child Behavior Checklist and the Schedule for Affective Disorders and Schizophrenia for School-Age Children.
Results:
Children of IDU parents exhibited high rates of psychopathology. Parental HIV infection per se had no discernible impact on children's outcomes. The apparent HIV infection of a parent was associated with an eightfold increase (odds ratio 7.80; 95% confidence interval 1.56-39.09) in the prevalence of disruptive behavior disorders (compared with children of HIV-negative parents). Parental depression was associated with a threefold increase in the prevalence of children's disruptive behavior disorders (odds ratio 3.49, 95% confidence interval 1.11-11.04).
Conclusions:
Parental HIV status per se does not seem to have a differential impact on the affected children. The apparent HIV infection of a parent may be associated with children's externalizing symptoms and disorders.