Psychological Functioning among Vertically Infected HIV-Positive Children & Their Primary Caregivers

The current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. 

A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger children's psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. 

In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes.

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By:  Lentoor AG1, Oppong Asante K2, Govender K3, Petersen I2.

• 1 Department of Psychology , University of the Witwatersrand , Johannesburg , South Africa.
• 2 Discipline of Psychology, School of Applied Human Sciences , University of KwaZulu-Natal , Durban , South Africa.
• 3 Heath Economics and HIV/AIDS Research Division (HEARD) , University of KwaZulu-Natal , Durban , South Africa. 
• AIDS Care. 2016 Feb 1:1-7. 

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Risk Factors for Incident HIV Infection among Antenatal Mothers in Rural Eastern Cape, South Africa

BACKGROUND:

The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa.

OBJECTIVE:

To establish the risk factors for incident HIV infection among antenatal clients aged 18-49 years attending public antenatal clinics in rural Eastern Cape, South Africa.

DESIGN:

This was an unmatched case-control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant.

RESULTS:

The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol.

CONCLUSIONS:

Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

Below:  Map showing the geographical location of King Sabata District Municipality, Eastern Cape, South Africa.

Table 2.  Independent risk factors for HIV infection

Independent variables	B	SE	Chi-square Wald	OR	95% CI	p
Main source of economic support
Partner	2.770	0.406	46.530	16	7.2–35.4	<0.0001
Family/other			Reference	1
Engagement in sex under the influence of alcohol
Yes	3.048	0.508	36.004	21.1	7.8–57	<0.0001
No			Reference	1
Age of partner
≥25 years	3.096	0.495	39.142	22.1	8.4–58.3	<0.0001
<25 years			Reference	1
Constant	−5.502	0.671	67.165			<0.0001

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By:  Businge CB1, Longo-Mbenza B2, Mathews V3.

• 1Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa.
• 2Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa; longombenza@gmail.com.
• 3School of Public Health, University of Western Cape, Cape Town, South Africa. 
• Glob Health Action. 2016 Jan 20;9:29060. doi: 10.3402/gha.v9.29060. eCollection 2016.

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