Longitudinal study of emerging mental health concerns in youth perinatally infected with HIV and peer comparisons

J Dev Behav Pediatr. 2012 Jul;33(6):456-68. doi: 10.1097/DBP.0b013e31825b8482.


Objective: Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time.

Methods: Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in households with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors.

Results: Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively).

Conclusions: Many youth in families affected by HIV are at risk for development of psychiatric symptoms.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use
  • Anxiety, Separation / drug therapy
  • Anxiety, Separation / epidemiology
  • Anxiety, Separation / psychology
  • Attention Deficit Disorder with Hyperactivity / drug therapy
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Attention Deficit and Disruptive Behavior Disorders / diagnosis
  • Attention Deficit and Disruptive Behavior Disorders / drug therapy
  • Attention Deficit and Disruptive Behavior Disorders / epidemiology
  • Attitude to Health*
  • Case-Control Studies
  • Child
  • Child of Impaired Parents / psychology
  • Cross-Sectional Studies
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Drug Utilization
  • Female
  • HIV Infections / congenital*
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • HIV Infections / transmission*
  • HIV Seropositivity / congenital*
  • HIV Seropositivity / drug therapy
  • HIV Seropositivity / psychology*
  • HIV Seropositivity / transmission
  • Humans
  • Incidence
  • Infectious Disease Transmission, Vertical*
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology*
  • Peer Group*
  • Personality Assessment / statistics & numerical data
  • Psychometrics
  • Psychotropic Drugs / therapeutic use
  • Social Environment
  • Social Stigma
  • Viral Load


  • Anti-HIV Agents
  • Psychotropic Drugs