title: Psychosocial issues in children and adolescents with HIV infection evaluated with a World Health Organization age-specific descriptor system.
abstract: OBJECTIVE
  After active antiretroviral therapy, children with HIV are clinically well, whereas psychosocial issues continue to influence their quality of life. The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization evaluates health status and environmental and social factors associated with health. We investigated the efficacy of the ICF to describe the health status and needs of a cohort of children and adolescents with HIV seen at a reference center for pediatric AIDS in Europe.
  
  
  METHODS
  A quantitative analysis of structured interviews was performed. Caregivers of children and adolescents with HIV infection in follow-up at 2 reference centers for pediatric AIDS were enrolled. Four major areas included in the ICF instrument were investigated: impairments of body structures; impairments of body functions; environmental factors; and activity limitations and restrictions to social life.
  
  
  RESULTS
  Forty-one families of children with HIV were enrolled. Body structures and functions were marginally impaired, whereas environmental factors and psychosocial issues had a relevant impact on quality of life. Most families considered environmental factors to be "barriers"; these were poverty, unemployment, and single-parent family structure. Activity limitations and social restrictions were also reported in a few cases. Almost all parents reported problems in disclosing their child's HIV status because of the fear of social stigma.
  
  
  CONCLUSIONS
  Psychosocial issues are part of the well-being of children with HIV. The ICF is a standard tool to evaluate the clinical and psychosocial status of children and adolescents with HIV infection and to measure the impact of therapeutic interventions and strategies on psychosocial functioning.
authors.affiliation: Department of Pediatrics, University Federico II, Naples, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Giannattasio
authors.forename: Annunziata
authors.initials: A
authors.lastname: Officioso
authors.forename: Grazia Isabella
authors.initials: GI
authors.lastname: Continisio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Griso
authors.forename: Cinzia
authors.initials: C
authors.lastname: Storace
authors.forename: Simonetta
authors.initials: S
authors.lastname: Coppini
authors.forename: Daniela
authors.initials: D
authors.lastname: Longhi
authors.forename: Carmela
authors.initials: C
authors.lastname: Mango
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Badolato
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pisacane
mesh_terms: D000293:Adolescent; D000375:Aging / Q000523:psychology*; D002648:Child; D004185:Disability Evaluation; D005060:Europe; D005239:Fear / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D010290:Parents; D011788:Quality of Life / Q000523:psychology*; D012931:Social Environment; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014944:World Health Organization