Executive Functioning in Children and Adolescents With Perinatal HIV Infection

Area of Science:

• Neuroscience
• Pediatrics
• Psychology

Background:

• Perinatal HIV (PHIV) infection is a potential risk factor for executive functioning (EF) impairments in youth.
• Understanding EF in youth with PHIV is crucial for identifying those at risk for adverse health and behavioral outcomes.

Purpose of the Study:

• To examine the associations of executive functioning (EF) with HIV infection status, disease severity, and other factors in youth with PHIV and perinatally HIV-exposed, uninfected (PHEU) youth.
• To compare EF performance between PHIV and PHEU youth using objective and subjective measures.

Main Methods:

• Utilized data from the US-based Pediatric HIV/AIDS Cohort Study, including 354 PHIV and 200 PHEU youth.
• Administered the Children's Color Trails Test (CCTT) for objective EF assessment and the Behavior Rating Inventory of Executive Function (BRIEF) for caregiver/youth-reported everyday EF.
• Employed linear regression, logistic regression, and proportional odds models, controlling for covariates like disease severity and demographic factors.

Main Results:

• No significant differences in CCTT performance between PHIV and PHEU groups.
• Caregivers reported fewer EF problems for PHIV youth compared to PHEU youth on the BRIEF.
• PHIV youth with a history of encephalopathy exhibited slower CCTT performance and reported more metacognitive problems on the BRIEF.
• Both CCTT and BRIEF scores correlated significantly with indicators of past and present disease severity.
• Both PHIV and PHEU youth scored below population means on CCTT and BRIEF, with scores associated with demographic covariates.

Conclusions:

• Executive functioning (EF) challenges in youth with PHIV are likely influenced by factors beyond HIV infection itself.
• Cognitive slowing and self-reported metacognitive difficulties were observed in PHIV youth with a history of encephalopathy.
• Targeted assessment and intervention for EF impairments are vital for identifying and supporting PHIV youth at higher risk for poor health and behavioral outcomes.