title: Community-Based Needs Assessment of Neurodevelopment, Caregiver, and Home Environment Factors in Young Children Affected by HIV in Lima, Peru.
abstract: In many resource-poor settings such as Peru, children affected by HIV have a high prevalence of neurodevelopmental delays (NDDs) and remain excluded from adequate treatment.
  
  
  
  Community health workers (CHWs) administered NDD screening instruments to assess child development and associated caregiver and household factors in 14 HIV-affected parent-child dyads. Focus group discussion with caregivers was conducted to explore their needs and behaviors around early child stimulation and to assess their perceptions of the screening experience.
  
  
  
  Over 70% of the children had abnormal classification in at least 1 (out of 5) developmental domains according to Ages and States Questionnaire-provided cutoff scores. Caregiver depression and stress were associated with abnormal development as were some parenting behavior factors. Knowledge about child development was low. Caregivers felt testing and discussing results with a CHW were very insightful. Reported caregiver behavior differed between caregivers with HIV-infected children and those with uninfected children.
  
  
  
  Taken together, these exploratory quantitative data suggest that parenting behaviors associated with low child development scores may be modifiable and that community-based testing is well received and informative to these HIV-infected caregivers.
authors.affiliation: 1 Socios En Salud, Lima, Peru.|Ms. Munoz and Ms. Nelson are co-first authors of this paper.
authors.forename: Maribel
authors.initials: M
authors.lastname: Muñoz
authors.affiliation: 2 Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.|Ms. Munoz and Ms. Nelson are co-first authors of this paper.
authors.forename: Adrianne
authors.initials: A
authors.lastname: Nelson
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Maureen
authors.initials: M
authors.lastname: Johnson
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Nancy
authors.initials: N
authors.lastname: Godoy
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Esther
authors.initials: E
authors.lastname: Serrano
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Engerid
authors.initials: E
authors.lastname: Chagua
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Jesica
authors.initials: J
authors.lastname: Valdivia
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Janeth
authors.initials: J
authors.lastname: Santacruz
authors.affiliation: 1 Socios En Salud, Lima, Peru.
authors.forename: Milagros
authors.initials: M
authors.lastname: Wong
authors.affiliation: 3 Infectious Disease, Instituto Nacional del Salud del Niño, Lima, Peru.
authors.forename: Lenka
authors.initials: L
authors.lastname: Kolevic
authors.affiliation: 4 Boston Children's Hospital, Boston, MA, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Kammerer
authors.affiliation: 4 Boston Children's Hospital, Boston, MA, USA.
authors.forename: Clemente
authors.initials: C
authors.lastname: Vega
authors.affiliation: 5 SPARK Center, Mattapan, MA, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Vibbert
authors.affiliation: 6 University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Lundy
authors.affiliation: 1 Socios En Salud, Lima, Peru.|7 Department of Infectious Disease, Brigham and Women's Hospital, Boston, MA, USA.|8 Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Sonya
authors.initials: S
authors.lastname: Shin
mesh_terms: D017028:Caregivers; D002657:Child Development; D002675:Child, Preschool; D003150:Community Health Workers; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007223:Infant; D020380:Needs Assessment; D011446:Prospective Studies; D011634:Public Health; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: child development; children affected by HIV; community health; community health workers; training