Advertisement

AIDS and Behavior

, Volume 21, Issue 6, pp 1601–1610 | Cite as

Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth

  • Mary Jane Rotheram-BorusEmail author
  • Mark Tomlinson
  • Aaron Scheffler
  • Danielle M. Harris
  • Sandahl Nelson
Original Paper

Abstract

Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH’s children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p < .10) over time (i.e., lower weight-for-age Z-scores) and were also hospitalized significantly more often than children of MWOH (p < .01). Children of MLH and MWOH died at similar rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.

Keywords

Mothers living with HIV Maternal child health Low and middle income countries PMTCT Community health workers 

Notes

Acknowledgments

This study was funded by NIAAA Grant # 1R01AA017104 and supported by NIH Grants R24AA022919, P30MH058107, 5P30AI028697, Ilifa Labantwana, and UCLA CTSI UL1TR000124.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369(9555):60–70.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Horton R, Lo S. Nutrition: a quintessential sustainable development goal. Lancet. 2013;382(9890):371–2.CrossRefPubMedGoogle Scholar
  3. 3.
    Eholié SP, Aoussi FE, Ouattara IS, Bissgagnéné E, Anglaret X. HIV treatment and care in resource-constrained environments: challenges for the next decade. J Int AIDS Soc. 2012;15(2):17334.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). A progress report on the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. 2012. http://www.unaids.org/sites/default/files/media_asset/JC2385_ProgressReportGlobalPlan_en_0.pdf. Accessed 4 April 2016.
  5. 5.
    UNAIDS. Women out loud: how women living with HIV will help the world end AIDS. 2012. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/unaidspublication/2012/20121211_Women_Out_Loud_en.pdf. Accessed 4 April 2016.
  6. 6.
    UNAIDS. The Gap Report. 2014. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf. Accessed 4 April 2016.
  7. 7.
    UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. 2013. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Global_Report_2013_en_1.pdf. Accessed 4 April 2016.
  8. 8.
    Statistics South Africa. Statistical Release P0302: Mid-Year Population Estimates. 2015. https://www.statssa.gov.za/publications/P0302/P03022015.pdf. Accessed 4 April 2016.
  9. 9.
    Kalembo FW, Zgambo M. Loss to followup: a major challenge to successful implementation of prevention of mother-to-child transmission of HIV-1 programs in Sub-Saharan Africa. ISRN AIDS. 2012;2012:598817.CrossRefGoogle Scholar
  10. 10.
    Berer M. Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women’s survival. Bull World Health Organ. 1999;77(11):871–7.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Institute of Medicine (US) Committee on Reviewing the HIVNET 012 Perinatal HIV Prevention Study. Review of the HIVNET 012 Perinatal HIV Prevention Study. Washington: National Academies Press (US); 2005.Google Scholar
  12. 12.
    Rotheram-Borus MJ, Rice E, Comulada WS, Best K, Li L. Comparisons of HIV-affected and non-HIV-affected families over time. Vulnerable Child Youth Stud. 2012;7(4):299–314.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Luoma I, Tamminen T, Kaukonen P, et al. Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry. 2001;40(12):1367–74.CrossRefPubMedGoogle Scholar
  14. 14.
    Murray L, Cooper PJ, Wilson A, Romaniuk H. Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: impact on the mother-child relationship and child outcome. Br J Psychiatry. 2003;182:420–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Gardner EM, McLees P, Steiner JF, del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. 2011;52(6):793.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Maman S, Mbwambo J, Hogan NM, Kilonzo GP, Sweat M. Women’s barriers to HIV-1 testing and disclosure: challenges for HIV-1 voluntary counselling and testing. AIDS Care. 2001;13(5):595–603.CrossRefPubMedGoogle Scholar
  17. 17.
    Medley A, Garcia-Moreno C, McGill S, Maman S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bull World Health Organ. 2004;82(4):299–307.PubMedPubMedCentralGoogle Scholar
  18. 18.
    French H, Greeff M, Watson MJ, Doak CM. HIV stigma and disclosure experiences of people living in an urban and a rural setting. AIDS Care. 2015;27(8):1042–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Mahajan AP, Sayles JN, Patel VA, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Davis E, Rotheram-Borus MJ, Tomlinson M. The relationship between South African families’ alcohol use, depression, and domestic violence on daily routines. In submission .Google Scholar
  21. 21.
    McIntosh RC, Rosselli M. Stress and coping in women living with HIV: a meta-analytic review. AIDS Behav. 2012;16:2144–59.CrossRefPubMedGoogle Scholar
  22. 22.
    Li X, Chi P, Sherr L, Cluver L, Stanton B. Psychological resilience among children affected by parental HIV/AIDS: a conceptual framework. Health Psychol Behav Med. 2015;3(1):217–35.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Murphy DA, Marelich WD. Resiliency in young children whose mothers are living with HIV/AIDS. AIDS Care. 2008;20(3):284–94.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Magadi MA. Household and community HIV/AIDS status and child malnutrition in sub-Saharan Africa: evidence form the demographic health surveys. Soc Sci Med. 2011;73(3):436–46.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    United Nations Department of Economic and Social Affairs/Population Division. The impact of AIDS—Impact on households. 2004. http://www.un.org/esa/population/publications/AIDSimpact/6_CHAP_III.pdf. Accessed 4 April 2016.
  26. 26.
    England MJ, Sim LJ. Depression in parents, parenting, and children: opportunities to improve identification, treatment, and prevention. Washington: The National Academies Press; 2009.Google Scholar
  27. 27.
    Hanington L, Ramchandani P, Stein A. Parental depression and child temperament: assessing child to parent effects in a longitudinal population study. Infant Behav Dev. 2010;33(1):88–95.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Moss WJ, Clements JC, Halsey NA. Immunization of children at risk of infection with human immunodeficiency virus. Bull World Health Organ. 2003;81(1):61–70.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Mphahlele MJ, Mda S. Immunising the HIV-infected child: a view from sub-Saharan Africa. Vaccine. 2012;30S:C61–5.CrossRefGoogle Scholar
  30. 30.
    Rotheram-Borus MJ, le Roux IM, Tomlinson M, et al. Philani Plus (+): a Mentor Mother community health worker home visiting program to improve maternal and infants’ outcomes. Prev Sci. 2011;12(4):372–88.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Rotheram-Borus MJ, Rice E, Comulada WS, et al. Intervention outcomes among HIV-affected families over 18 months. AIDS Behav. 2012;16(5):1265–75.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    le Roux IM, Tomlinson M, Harwood JM, et al. Outcomes of home visits for pregnant mothers and their Infants: a cluster randomised controlled trial. AIDS. 2013;27(9):1461.CrossRefPubMedGoogle Scholar
  33. 33.
    Rotheram-Borus MJ, Richter LM, van Heerden A, et al. A cluster randomized controlled trial evaluating the efficacy of peer mentors to support South African women living with HIV and their infants. PLoS One. 2014;9(1):e84867.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    de Onis M, Blossner M. The World Health Organization global database on child growth and malnutrition: methodology and applications. Int J Epidemiol. 2003;32:518–26.CrossRefPubMedGoogle Scholar
  35. 35.
    Dunn LM, Dunn LM, Bulheller S, Häcker H. Peabody picture vocabulary test. Circle Pines: American Guidance Service; 1965.Google Scholar
  36. 36.
    Pakendorf C, Alant E. Culturally valid assessment tools: northern Sotho translation of the Peabody Picture Vocabulary Test-Revised. S Afr J Commun Disord. 1997;44:3–12.PubMedGoogle Scholar
  37. 37.
    Blair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev. 2007;78(2):647–63.CrossRefPubMedGoogle Scholar
  38. 38.
    Blair C, Zelazo PD, Greenberg MT. The measurement of executive function in early childhood. Dev Neuropsychol. 2005;28(2):561–71.CrossRefPubMedGoogle Scholar
  39. 39.
    Achenbach TM. Manual for the child behavior checklist 11/2-5. Burlington: University of Vermont, Department of Psychiatry; 2000.Google Scholar
  40. 40.
    Goodman R. The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581–6.CrossRefPubMedGoogle Scholar
  41. 41.
    Stone LL, Otten R, Engels RCME, Vermulst AA, Janssens JMAM. Psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire for 4- to 12-year-olds: a review. Clin Child Fam Psychol Rev. 2010;13(3):254–74.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Croft S, Stride C, Maughan B, Rowe R. Validity of the strengths and difficulties questionnaire in preschool-aged children. Pediatrics. 2015;135(5):e1210.CrossRefPubMedGoogle Scholar
  43. 43.
    Sharp C, Venta A, Marais L, Skinner D, Lenka M, Serekoane J. First evaluation of a population-based screen to detect emotional-behavior disorders in orphaned children in Sub-Saharan Africa. AIDS Behav. 2014;18(6):1174–85.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression—development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Lawrie TA, Hofmeyr GJ, de Jager M, Berk M. Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women. S Afr Med J. 1998;88(10):1340–4.PubMedGoogle Scholar
  46. 46.
    Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974;19(1):1–15.CrossRefPubMedGoogle Scholar
  47. 47.
    Dawson DA, Grant BF, Stinson FS. The AUDIT-C: screening for alcohol use disorders and risk drinking in the presence of other psychiatric disorders. Compr Psychiatry. 2005;46(6):405–16.CrossRefPubMedGoogle Scholar
  48. 48.
    Reinert DF, Allen JP. The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res. 2007;31:185–99.CrossRefPubMedGoogle Scholar
  49. 49.
    Rotheram-Borus MJ, Scheffler A, Tomlinson M, le Roux IM. Re-engagement in HIV care among mothers living with HIV in South Africa over 36 months post-birth. AIDS. 2015;29(17):2361–2.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Nöthling J, Martin CL, Laughton B, Cotton MF, Seedat S. Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother–child dyads infected with HIV: a longitudinal study. BMJ Open. 2013;3:e003638.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Rotheram-Borus MJ, Lee M, Leonard N, et al. Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children. AIDS. 2003;17(8):1217–25.CrossRefPubMedGoogle Scholar
  52. 52.
    Lee M, Rotheram-Borus MJ. Challenges associated with increased survival among parents living with HIV. Am J Public Health. 2001;91(8):1303–9.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). 2015 progress report on the global plan towards the elimination of new HIV infections among children and keeping their mothers alive. UNAIDS. 2015. http://www.unaids.org/sites/default/files/media_asset/JC2774_2015ProgressReport_GlobalPlan_en.pdf. Accessed 16 May 2016.
  54. 54.
    Lawn J, Kerber K. Opportunities for Africa’s newborns: practical data, policy and programmatic support for newborn care in Africa. World Health Organization (WHO). 2006. http://www.who.int/pmnch/media/publications/oanfullreport.pdf. Accessed 4 April 2016.

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Mary Jane Rotheram-Borus
    • 1
    Email author
  • Mark Tomlinson
    • 2
  • Aaron Scheffler
    • 1
  • Danielle M. Harris
    • 1
  • Sandahl Nelson
    • 1
  1. 1.Department of Psychiatry & Biobehavioral Sciences, Semel InstituteUniversity of California at Los AngelesLos AngelesUSA
  2. 2.Department of PsychologyStellenbosch UniversityMatielandSouth Africa

Personalised recommendations