Children of mothers with HIV/AIDS: unmet needs for mental health services

Pediatrics. 2007 Nov;120(5):e1141-7. doi: 10.1542/peds.2005-2680. Epub 2007 Oct 22.

Abstract

Objective: The objective of this study was to use multiple measures and sources to assess mental health over time in uninfected 8- to 12-year-old children of HIV-positive mothers.

Methods: We recruited from the New York City Division of AIDS Services and Income Support a consecutive sample of 157 single mothers who were living with an HIV-negative child aged 8 to 12. Families were randomly assigned to receive a custody planning intervention, Project Care, or standard care. Data were collected at baseline and 4 subsequent times 6 months apart. Children completed the Children's Depression Inventory; 8- to 10-year-olds completed the Terry, and 11- to 12-year-olds completed the Youth Self-Report. Mothers completed the Child Behavior Checklist. Each measure has a validated cutoff score to signify clinically significant symptoms.

Results: All 5 data points were available on 129 (82%) children. During 2 years, every child had a score in the clinical range (12% once, 25% twice, 26% 3 times, 27% 4 times, and 9% all 5 times). Clinically significant symptoms were most likely at baseline when mothers were sickest. Few had clinically significant symptoms based on maternal report only (5%) or child report only (8%). Chronicity of clinically significant symptoms was not related to child age or gender, maternal health or depression, parent-child relationship, or being assigned to Project Care. Although two thirds of the children received mental health services during the study, <25% did at any 1 time, and 28% of children with chronic clinically significant symptoms never received care.

Conclusions: Children who are affected by AIDS should be routinely screened for psychiatric problems by using multiple measures and sources to avoid underidentification and be carefully monitored long-term.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Acquired Immunodeficiency Syndrome* / psychology
  • Adult
  • Child
  • Child of Impaired Parents / psychology*
  • Female
  • Follow-Up Studies
  • HIV Infections* / psychology
  • Health Services Needs and Demand* / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services* / statistics & numerical data
  • Mother-Child Relations*
  • Mothers / psychology