Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth.
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.
Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA. CCHPublications@mednet.ucla.edu.
Mary Jane
MJ
Rotheram-Borus
Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
Mark
M
Tomlinson
Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
Aaron
A
Scheffler
Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
Danielle M
DM
Harris
Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
Sandahl
S
Nelson
D000223:Adaptation, Psychological; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D013019:South Africa / Q000453:epidemiology; D014505:Urban Population
Community health workers; Low and middle income countries; Maternal child health; Mothers living with HIV; PMTCT