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Perinatal HIV exposure and infection and caregiver depressive symptoms

Sarah K Brewer1, Nicole Talge1, Claudia Holzman1

  • 1Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.

AIDS Care
|June 23, 2023
PubMed

Insights

Caregivers of children with perinatal HIV exposure but no infection (CPHEU) in Uganda reported higher depressive symptoms than caregivers of children with HIV infection (CPHIV). This highlights unmet mental health needs in the CPHEU group.

Area of Science:

  • Global Health
  • Pediatric Infectious Diseases
  • Mental Health Research

Background:

  • Children perinatally exposed to or infected by HIV (CPHIV) can survive in the post-combined antiretroviral therapy era.
  • Caregiver mental health significantly impacts child development, yet research in HIV-endemic settings has not fully explored this across all HIV exposure/infection groups.
  • Understanding caregiver mental health is crucial for the well-being of children affected by HIV.

Purpose of the Study:

  • To compare depressive symptoms among caregivers of children with perinatally acquired HIV infection (CPHIV), perinatal HIV exposure without infection (CPHEU), and no HIV exposure or infection (CHUU) in Uganda.
  • To identify factors influencing depressive symptoms in caregivers of these distinct pediatric HIV groups.
  • To address the public health significance of identifying factors affecting children's ability to thrive.

Main Methods:

  • A comparative study was conducted in Uganda involving caregivers of 6-10-year-old children across three groups: CPHIV (n=102), CPHEU (n=101), and CHUU (n=103).
  • Depressive symptoms were assessed using the Hopkins Symptom Checklist.
  • Generalized linear models were employed to estimate group mean differences, with adjusted models incorporating caregiver demographics, social support, and lifetime trauma.

Main Results:

  • Caregivers of children with perinatal HIV exposure but no infection (CPHEU) reported significantly higher depressive symptoms compared to caregivers of children with perinatally acquired HIV infection (CPHIV).
  • This difference persisted after adjusting for covariates and remained significant among biological mothers.
  • Lower levels of social support and wealth were associated with higher depression symptoms in CPHEU caregivers compared to CPHIV caregivers.

Conclusions:

  • Unmet mental health needs exist among caregivers of children with perinatal HIV exposure but no infection (CPHEU).
  • Targeted mental health support is crucial for CPHEU caregivers to promote child well-being.
  • Further research should investigate the specific factors contributing to higher depression rates in this vulnerable caregiver group.

Keywords:
HIV/AIDSPerinatalcaregiver depressionsub-saharan Africa

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