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Mental health treatment patterns in perinatally HIV-infected youth and controls

Miriam Chernoff1, Sharon Nachman, Paige Williams

  • 1Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts 02115, USA. mchernoff@sdac.harvard.edu

Pediatrics
|July 15, 2009
PubMed

Insights

HIV-positive children receive more mental health interventions, including psychotropic medications and behavioral treatments, than their peers. Pediatricians and caregivers should explore all available mental health options for children in HIV-affected families.

Area of Science:

  • Pediatric mental health
  • HIV/AIDS clinical research
  • Psychiatric epidemiology

Background:

  • Youths perinatally infected with HIV often require psychotropic medication and behavioral interventions for emotional and behavioral symptoms.
  • Understanding intervention patterns is crucial for managing the mental health of HIV-positive youth.

Purpose of the Study:

  • To describe and compare the patterns of psychotropic medication and behavioral treatment utilization in HIV-positive youth versus a control group in the United States.

Main Methods:

  • A prospective, 2-year observational study (International Maternal Adolescent AIDS Clinical Trials 1055) involving 319 HIV-positive youth and 256 controls (aged 6-17).
  • Data collected included caregiver and child-reported symptom scales, and histories of psychiatric medication and behavioral interventions.
  • Multiple logistic regression was used to assess the association between HIV status and intervention, controlling for confounders.

Main Results:

  • Prevalence of psychiatric symptoms (61%) and impairment (14-15%) were similar between HIV-positive youth and controls.
  • HIV-positive youth were more likely to receive psychotropic medication (23% vs 12%) and behavioral treatment (27% vs 17%).
  • HIV-positive children had significantly higher odds of receiving stimulants and antidepressants compared to controls, even after adjustment.

Conclusions:

  • HIV-positive children are significantly more likely to receive mental health interventions than children in control groups.
  • Caregiver-reported symptoms and impairment strongly predicted intervention receipt.
  • Healthcare providers and caregivers should proactively consider mental health support for all children in families impacted by HIV.
Abstract

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