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Mental health and adaptive functioning among school-aged children living with HIV in Zambia
Lisa Kalungwana1,2, Susan Malcolm-Smith2, Leigh Schrieff2
1Department of Psychology, University of Zambia, Lusaka, Zambia.
Insights
Children living with HIV (CLWHIV) show increased mental health issues, particularly in executive functioning and aggressiveness. Support is needed to address these challenges as they grow.
Area of Science:
- Pediatric Health
- Neuroscience
- Psychology
Background:
- Increasing numbers of children living with HIV (CLWHIV) present with higher morbidity, including neurocognitive and mental health challenges.
- Sub-Saharan Africa has the highest burden of CLWHIV, yet research on HIV's impact on child mental health and adaptive functioning remains limited.
Purpose of the Study:
- To assess and compare mental health and adaptive functioning in children living with HIV (CLWHIV) and their HIV-uninfected peers.
- To identify specific areas of mental health and adaptive functioning affected by HIV in children.
Main Methods:
- A sample of 120 children (62 CLWHIV, 58 HIV-uninfected), aged 6-12 years, were assessed.
- Mental health was evaluated using the Connors scale, and adaptive functioning using the Vineland Adaptive Behavioral Scale (VABS).
Main Results:
- CLWHIV exhibited significantly higher mental health problems in executive functioning and aggressiveness compared to HIV-uninfected children.
- While not statistically significant, CLWHIV showed lower VABS Communication scores but significantly higher Daily Living Skills scores.
- CLWHIV also had significantly higher scores on the internalizing and externalizing maladaptive behavior subdomains of the VABS.
Conclusions:
- Mental health and adaptive functioning challenges persist among CLWHIV.
- Findings underscore the necessity for targeted support systems to address the mental health and adaptive functioning needs of CLWHIV as they transition into adolescence.
Background:
The number of children living with HIV (CLWHIV) has been increasing, reflected by lower mortality. However, this change is coupled with higher rates of morbidity, where CLWHIV face considerable challenges, including neurocognitive delays and mental health and behavioral functioning challenges. Despite Sub-Sahara accounting for the highest number of CLWHIV, there is still limited research on the effects of HIV on child mental health and adaptive functioning.
Method:
Mental health and adaptive functioning were assessed in 120 children. The sample included 62 CLWHIV and 58 demographically-matched HIV-uninfected children aged 6-12 years. Mental health was assessed using the Connors, while adaptive functioning was assessed using the Vineland Adaptive Behavioral Scale (VABS).
Results:
Scores obtained were within average ranges for mental health (T-score 40-59) and adaptive functioning standard scores (70-115). However, CLWHIV had significantly higher mental health problems than uninfected children in executive functioning and aggressiveness (p < 0.05). CLWHIV had lower adaptive functioning scores on the VABS Communication domain although these differences were not significant. In the Daily Living Skills domain, CLWHIV had significantly higher scores than the HIV-uninfected children (p < 0.05). There were no significant differences in the Socialization subdomain. Furthermore, CLWHIV had significantly higher scores on the Maladaptive Behavior scales of the VABS' internalizing and externalizing subdomains.
Conclusion:
Challenges to mental health and adaptive functioning are still pervasive among CLWHIV. These findings support the need to develop support mechanisms for CLWHIV to help address mental health and adaptive functioning problems, especially as they progress into adolescence.
