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AIDS. 2014 Jul;28 Suppl 3:S261-8. doi: 10.1097/QAD.0000000000000328.

Predicting long-term outcomes for children affected by HIV and AIDS: perspectives from the scientific study of children's development.

Author information

1
aSection of Child & Adolescent Psychiatry, University of Oxford, Oxford and School of Public Health, University of Witwatersrand bHuman and Social Development Research Programme, Human Sciences Research Council, Durban cDepartment of Psychology, Loyola University, Chicago dCentre for Child and Family Studies, Graduate School of Social and Behavioural Sciences, Leiden University, The Netherlands eCenter for Children, Families and Schools, Tulane University, New Orleans fDepartment of Pediatrics, University of Maryland School of Medicine, Baltimore gHubert Department of Global Health, Emory University, Atlanta hNational Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta iDepartment of Psychology, University of Connecticut, Storrs jDivision of Violence Prevention, National Center for Injury Prevention and Control kSection of Child & Adolescent Psychiatry, University of Oxford, Oxford lDivision of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta mHIV/AIDS, STIs, and TB Research Programme, Human Sciences Research Council, Durban.

Abstract

The immediate and short-term consequences of adult HIV for affected children are well documented. Little research has examined the long-term implications of childhood adversity stemming from caregiver HIV infection. Through overviews provided by experts in the field, together with an iterative process of consultation and refinement, we have extracted insights from the broader field of child development of relevance to predicting the long-term consequences to children affected by HIV and AIDS. We focus on what is known about the impact of adversities similar to those experienced by HIV-affected children, and for which there is longitudinal evidence. Cautioning that findings are not directly transferable across children or contexts, we examine findings from the study of parental death, divorce, poor parental mental health, institutionalization, undernutrition, and exposure to violence. Regardless of the type of adversity, the majority of children manifest resilience and do not experience any long-term negative consequences. However, a significant minority do and these children experience not one, but multiple problems, which frequently endure over time in the absence of support and opportunities for recovery. As a result, they are highly likely to suffer numerous and enduring impacts. These insights suggest a new strategic approach to interventions for children affected by HIV and AIDS, one that effectively combines a universal lattice of protection with intensive intervention targeted to selected children and families.

PMID:
24991899
DOI:
10.1097/QAD.0000000000000328
[Indexed for MEDLINE]

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