Abstract
AIM—To ascertain the psychological, social, and educational needs of children born to mothers with HIV infection. METHODS—Review of case records of 120 children and 86mothers. RESULTS—The cohort of 120 children were born to 92 women, and followed up for a median duration of 48 months (mean (SD) 51.1 (34.1), range 0.3-132). Sixteen children were infected with HIV, 15 were of indeterminate status, and 89 uninfected. Eighty one children (68%) were cared for by their birth mother, of whom 52% were single women and 23 (38% of 61) known to have symptomatic HIV disease. Twenty five mothers of 32 children had died; the child's mean (SD) age at maternal death was 66.9 months (37.7) (range 4-128). Compared with uninfected children, more infected children knew of their mother's diagnosis (31% v 5%) and mothers were also more likely to disclose their own illness to educational authorities (77% v 13%). A larger proportion of infected children had special educational needs (69% v 13%). Only 33 children (28%) were known not to be receiving any support from the voluntary or statutory agencies. CONCLUSION—The results highlight the multiple needs of children living with maternal HIV infection, which require dedicated resources and commitment from health, education, and social work agencies and the voluntary sector. We propose the model of chronic illness as the standard of care for these children.
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- British HIV Association guidelines for antiretroviral treatment of HIV seropositive individuals. BHIVA Guidelines Co-ordinating Committee. Lancet. 1997 Apr 12;349(9058):1086–1092. [PubMed] [Google Scholar]
- Connor E. M., Sperling R. S., Gelber R., Kiselev P., Scott G., O'Sullivan M. J., VanDyke R., Bey M., Shearer W., Jacobson R. L. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994 Nov 3;331(18):1173–1180. doi: 10.1056/NEJM199411033311801. [DOI] [PubMed] [Google Scholar]
- Grubman S., Gross E., Lerner-Weiss N., Hernandez M., McSherry G. D., Hoyt L. G., Boland M., Oleske J. M. Older children and adolescents living with perinatally acquired human immunodeficiency virus infection. Pediatrics. 1995 May;95(5):657–663. [PubMed] [Google Scholar]
- Levine C. Orphans of the HIV epidemic: unmet needs in six US cities. AIDS Care. 1995;7 (Suppl 1):S57–S62. doi: 10.1080/09540129550126830. [DOI] [PubMed] [Google Scholar]
- Lobato M. N., Caldwell M. B., Ng P., Oxtoby M. J. Encephalopathy in children with perinatally acquired human immunodeficiency virus infection. Pediatric Spectrum of Disease Clinical Consortium. J Pediatr. 1995 May;126(5 Pt 1):710–715. doi: 10.1016/s0022-3476(95)70397-7. [DOI] [PubMed] [Google Scholar]
- Melvin D., Sherr L. The child in the family--responding to AIDS and HIV. AIDS Care. 1993;5(1):35–42. doi: 10.1080/09540129308258582. [DOI] [PubMed] [Google Scholar]
- Mok J. Y., Hague R. A., Yap P. L., Hargreaves F. D., Inglis J. M., Whitelaw J. M., Steel C. M., Eden O. B., Rebus S., Peutherer J. F. Vertical transmission of HIV: a prospective study. Arch Dis Child. 1989 Aug;64(8):1140–1145. doi: 10.1136/adc.64.8.1140. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mok J. Y., Ross A., Raab G., Hamilton B., Gilkison S., Johnstone F. D. Maternal HIV and drug use: effect on health and social morbidity. Arch Dis Child. 1996 Mar;74(3):210–214. doi: 10.1136/adc.74.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Niebuhr V. N., Hughes J. R., Pollard R. B. Parents with human immunodeficiency virus infection: perceptions of their children's emotional needs. Pediatrics. 1994 Mar;93(3):421–426. [PubMed] [Google Scholar]
- Papola P., Alvarez M., Cohen H. J. Developmental and service needs of school-age children with human immunodeficiency virus infection: a descriptive study. Pediatrics. 1994 Dec;94(6 Pt 1):914–918. [PubMed] [Google Scholar]
- Pinching A. J. Managing HIV disease after Delta. BMJ. 1996 Mar 2;312(7030):521–522. doi: 10.1136/bmj.312.7030.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ronald P. J., Robertson J. R., Duncan B. M., Thomson A. S. Children of parents infected with HIV in Lothian. BMJ. 1993 Mar 6;306(6878):649–650. doi: 10.1136/bmj.306.6878.649-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Semple S. J., Patterson T. L., Temoshok L. R., McCutchan J. A., Straits-Tröster K. A., Chandler J. L., Grant I. Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group. Women Health. 1993;20(4):15–36. doi: 10.1300/J013v20n04_02. [DOI] [PubMed] [Google Scholar]
- Sharland M., Gibb D., Tudor-Williams G., Walters S., Novelli V. Paediatric HIV infection. Arch Dis Child. 1997 Apr;76(4):293–296. doi: 10.1136/adc.76.4.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tardieu M., Mayaux M. J., Seibel N., Funck-Brentano I., Straub E., Teglas J. P., Blanche S. Cognitive assessment of school-age children infected with maternally transmitted human immunodeficiency virus type 1. J Pediatr. 1995 Mar;126(3):375–379. doi: 10.1016/s0022-3476(95)70451-5. [DOI] [PubMed] [Google Scholar]
- Tovo P. A., de Martino M., Gabiano C., Cappello N., D'Elia R., Loy A., Plebani A., Zuccotti G. V., Dallacasa P., Ferraris G. Prognostic factors and survival in children with perinatal HIV-1 infection. The Italian Register for HIV Infections in Children. Lancet. 1992 May 23;339(8804):1249–1253. doi: 10.1016/0140-6736(92)91592-v. [DOI] [PubMed] [Google Scholar]