Body image in children and adolescents diagnosed with the human immunodeficiency virus: a systematic review

Abstract

The bodily manifestations related to the human immunodeficiency virus (HIV) and its treatment with antiretroviral therapy (ART) negatively affect not only the physical but also the psychological health of children and adolescents diagnosed with HIV infection; including body image issues. [1][2][3][4][5] Morphological changes related to lipodystrophy include loss of fat normally located in the face, buttocks, and extremities (lipoatrophy), contributing to perceived thinness, or gains of fat in the breasts, abdomen, and neck (lipohypertrophy), contributing to perceived overweight. 1,2,5,6 Children and adolescents with HIV infection are at risk of dissatisfaction with their body image (i.e., the way the body is presented to each child). [3][4][5] Furthermore, in children and adolescents without an HIV diagnosis, body image can be influenced by numerous physical, psychological, environmental, and cultural factors as determined subjectively by each child, and these may include the child's sex, age, media, beliefs, race, and general values, all of which also apply to children and adolescents diagnosed with HIV infection. [3][4][5] Body image is a unique, dynamic, and multifaceted construction. Self-report body image assessment tools can take many forms, including questionnaires and scales with silhouettes, photos, or videos that represent stimuli with which respondents can compare and evaluate themselves. 7 The choice of an assessment instrument by an investigator should take into account the age group that will be assessed, the nature of the assessment method, and the psychometric properties of the instrument (eg, reliability and validity for the population and uses for the investigator). 9As noted above, assessing the body image of children and adolescents diagnosed with HIV infection is made important by the types of symptoms and medication (i.e., continuous ART) side effects that may redefine body contours and self-perceptions of these patients. [3][4][5] Conducting a