title: Caring for perinatally HIV-infected children: call for mental care for the children and the caregivers.
abstract: Antiretroviral therapy has dramatically improved the survival rate of perinatally HIV-infected children. For them to thrive, it is necessary to understand better their mental health issues. Caregivers play an important role in children's daily care and caregiver mental health may relate to children's mental health. However, this association has rarely been studied. Accordingly, the present study examined the associations between depression of caregivers and that of perinatally HIV-infected children in Kigali, Rwanda. We conducted a cross-sectional study of 475 perinatally HIV-infected children aged 7-14 years and their caregivers. We collected children's depression score data via face-to-face interviews with children using the Beck Depression Inventory for Youth. We also collected sociodemographic data using a semi-structured questionnaire with caregivers. In addition, we measured children's weight, height, and collected their clinical records. Data were analyzed via linear and logistic regression analyses. Of all children, 22% had symptoms of depression. Among those who had depressive symptoms (n= 105), 49% had never received psychological support. In both the linear and logistic regression analysis, caregiver's high depression scores were positively associated with children's higher depression scores (AOR: 3.064, 95% CI: 1.723, 4.855, and AOR: 1.759, 95% CI: 1.129, 2.740, respectively). Taking Efavirenz and low height-for-age were also positively associated with higher depression scores among HIV-infected children. Mental health needs to be addressed to improve quality of life of perinatally HIV-infected children. Caregiver's depression was positively associated with children's depressive symptoms. Caring for both children and the caregivers' mental health may prevent the mutual fostering of depression.
authors.affiliation: a Institute of Decision Science for a Sustainable Society (IDS3) , Kyushu University , Fukuoka , Japan.|b Department of Community and Global Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan.
authors.forename: Kimiyo
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: c Department of Health Promotion and Policy, School of Public Health and Health Sciences , University of Massachusetts-Amherst , Amherst , USA.
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Poudel
authors.affiliation: d Division of Obstetrics & Gynecology , King Faisal Hospital , Kigali , Rwanda.
authors.forename: John Muganda
authors.initials: JM
authors.lastname: Rwibasira
authors.affiliation: e Rwanda Biomedical Center , Kigali , Rwanda.
authors.forename: Adolphe
authors.initials: A
authors.lastname: Majyambere
authors.affiliation: e Rwanda Biomedical Center , Kigali , Rwanda.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mutabazi
authors.affiliation: e Rwanda Biomedical Center , Kigali , Rwanda.
authors.forename: Simon Pierre
authors.initials: SP
authors.lastname: Nyonsenga
authors.affiliation: e Rwanda Biomedical Center , Kigali , Rwanda.
authors.forename: Ribakare
authors.initials: R
authors.lastname: Muhayimpundu
authors.affiliation: b Department of Community and Global Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008603:Mental Health; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012432:Rwanda; D011795:Surveys and Questionnaires
keywords: HIV; caregiver; depression; infant; mental health