An article by Kenneth Gadow, PhD and colleagues in the July/August issue of the Journal of Developmental and Behavioral Pediatrics includes significant new information about the mental health needs of children affected in some way by HIV and provides important clues about why they have higher rates of psychiatric problems than children in the general population. Dr. Gadow is a professor in the Department of Psychiatry and Behavioral Science at Stony Brook University, and his Stony Brook colleague in this research, Dr. Sharon Nachman, is professor in the Department of Pediatrics.
The article reports the results of a longitudinal study of emerging mental health concerns in children and adolescents perinatally infected with HIV. Several previous studies conducted around the world have demonstrated that children infected with HIV have high rates of mental health problems. In this study of 296 young people perinatally infected with HIV and followed for 2 years, almost half (43%) either received medication for or were socially or academically impaired by psychiatric symptoms, In addition, 44% of them had received special education and 37% had interventions for emotional or behavioral problems. What is startling about Dr. Gadow’s findings, however, is that the burden of psychiatric problems was almost as severe for children in his comparison group (37% impaired or received medication). These were children who were not infected with HIV but were affected by the virus, either by having been exposed to it perinatally or by living with someone infected with it (typically both). These findings suggest that the disproportionately high rates of mental health problems in children infected with HIV cannot be fully explained only by biological changes caused by the virus or its treatment, but may also be associated with biological and social risk factors inherent in the family and caregiving environment.
In addition to the intrinsic problems associated with psychiatric disorders, the psychiatric problems of children infected with HIV have implications for the treatment of HIV because they may interfere with compliance with medication regimens, which typically involve taking multiple medications daily throughout life. Psychiatric problems also have important implications for public health because of their association with transmission of the virus through risky sexual behavior and illegal IV drug use.
