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

AIDS and Behavior volume 21, pages 1601–1610 (2017)Cite this article

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.

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Notes

  1. The adherence rates to PMTCT milestones have been previously reported and are not included in this report [31].

  2. Results available upon request from authors.

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Acknowledgments

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

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Affiliations

  1. Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA

    Mary Jane Rotheram-Borus, Aaron Scheffler, Danielle M. Harris & Sandahl Nelson

  2. Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa

    Mark Tomlinson

Authors
  1. Mary Jane Rotheram-Borus
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Corresponding author

Correspondence to Mary Jane Rotheram-Borus.

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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.

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

Additional information

Trial Registration: ClinicalTrials.gov registration # NCT00972699.

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Rotheram-Borus, M.J., Tomlinson, M., Scheffler, A. et al. Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth. AIDS Behav 21, 1601–1610 (2017). https://doi.org/10.1007/s10461-016-1436-4

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  • DOI: https://doi.org/10.1007/s10461-016-1436-4

Keywords

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