Thirty-year Perspective of the Long-term Survival, CD4 Percentage and Social Achievements of Perinatally HIV-infected Children as a Function of Their Birth Era

Vuppula, Sharon; Tyungu, Donna; Kaul, Aditya; Chandwani, Sulachni; Rigaud, Mona; Borkowsky, William

doi:10.1097/inf.0000000000001393

Cited by 5 publications

(5 citation statements)

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“…48 Two-thirds had received an HS diploma or the equivalent, but only 19% were in college. 58 High rates of incarceration (12%) and homelessness (16%) were reported, reflecting the challenges faced by many YAs in poor, urban communities. 59 There are several limitations of our study.…”

Section: Discussionmentioning

confidence: 99%

Behavioral Health and Adult Milestones in Young Adults With Perinatal HIV Infection or Exposure

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Behavioral Health and Adult Milestones in Young Adults With Perinatal HIV Infection or Exposure

et al. 2018

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“…Of these two studies we used the baseline outcomes of school functioning [ 44 , 47 ]. Studies with quantitative data compared the outcomes of school functioning of HIV-infected children with national norms (n = 15) [ 3 , 6 , 41 , 43 – 45 , 47 , 51 – 53 , 59 , 60 , 64 , 67 , 68 ], matched healthy controls (n = 3) [ 50 , 53 , 54 ], HIV-exposed uninfected children (n = 5) [ 46 , 52 , 57 , 59 , 68 ] or siblings or other children living in the same household (n = 4) [ 6 , 55 , 56 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Six studies applied a previously validated instrument measuring multiple aspects of school functioning, which were summarized in one general school functioning scale [ 50 , 53 , 58 , 59 , 63 , 65 ]. Other studies evaluated aspects of school functioning through self-designed questionnaires (n = 7) [ 3 , 45 , 54 – 56 , 61 , 62 ], reviews of medical records (n = 6) [ 42 , 48 , 49 , 62 , 67 , 69 ] or interviews (n = 5) [ 8 , 51 , 52 , 66 , 69 ]. See S3 Appendix for an overview of general study characteristics and key findings per study.…”

Section: Resultsmentioning

confidence: 99%

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School functioning of children with perinatal HIV-infection in high-income countries: A systematic review

et al. 2021

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Introduction Since the introduction of combination antiretroviral therapy, human immunodeficiency virus (HIV) infection is a manageable chronic disease. However, school-age children (4–18 years) living with HIV could still experience problems with functioning at school, due to the impact of the virus itself, medication, comorbidities and social stigma. School functioning covers academic achievement, school attendance, and social relationships and is of utmost importance to optimize normal participation. Methods To gain insight in school functioning problems of perinatally HIV-infected children, we performed a systematic review of the literature in multiple databases from January 1997 up to February 2019. Studies were included if they described outcomes of school functioning of school-age children perinatally infected with HIV, in high-income countries. Meta-analyses were performed for sufficiently comparable studies. Results and discussion Results from 32 studies show that HIV-infected children experience more problems in various areas of school functioning in comparison with national norms, matched healthy controls, siblings and HIV-exposed uninfected (HEU) children. The most pronounced differences concerned the usage of special educational services, general learning problems, and mathematics and reading performance scores. Comparisons with both national norms and siblings/HEU children show that the differences between HIV-infected children and siblings/HEU children were less pronounced. Moreover, siblings/HEU children also reported significantly worse outcomes compared to national norms. This suggests that problems in school functioning cannot be solely attributed to the HIV-infection, but that multiple socio-economic and cultural factors may play a role herein. Conclusion Perinatally HIV-infected children seem vulnerable to problems in various areas of school functioning. Therefore, monitoring of school functioning should be an important aspect in the care for these children. A family-focused approach with special attention to a child’s socio-environmental context and additional attention for siblings and HEU children, is therefore recommended.

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“…To our knowledge, there are only two reports examining similar milestones in longitudinal studies of YAPHIV and YAPHEU. In the Bellevue pediatric cohort study (birth years 1977–1978) conducted in New York City, 57% of YAPHIV, age 19 and older, had graduated high school or earned a GED [ 45 ]; YAPHEU were not included, thus limiting comparisons with the present study. Investigators with the Child and Adolescent Self‐Awareness and Health Study (CASAH; enrolment in 2003–2008) [ 46 ] reported on the attainment of young adult milestones among YAPHIV and YAPHEU, age 18–28 years, living in New York City: 67% graduated high school or earned a GED, 19% were in college, 42% were employed; 38% were neither in school nor working.…”

Section: Discussionmentioning

confidence: 99%

Ageing with HIV: a longitudinal study of markers of resilience in young adults with perinatal exposure to HIV, with or without perinatally acquired HIV

et al. 2022

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Introduction Medical challenges, including perinatally acquired HIV (PHIV), can be considered adversity with the potential to compromise individuals’ ability to meet societal expectations across the lifespan. Studies suggest that resilience, defined as positive adaptation in the context of adversity, helps individuals overcome challenges and improve their quality of life. Few longitudinal studies have examined resilience in young adults with perinatally acquired HIV (YAPHIV) or perinatal HIV exposure, uninfected (YAPHEU). We examined three young adult milestones, which can affect the life‐long quality of life, as markers of resilience: high school graduation, postsecondary education and current employment. Methods Analyses included YAPHIV and YAPHEU, ages 19–27 years, followed in longitudinal cohort studies: Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) (7–17 years) and AMP Up (≥18 years). Factors known to influence the attainment of milestones (outcomes) were examined: executive function, cognitive efficiency (working memory and processing speed), behavioural/social‐emotional functioning, parent/caregiver mental/physical health and cumulative risk. HIV disease markers for YAPHIV were examined. The most recent AMP assessment was used for each factor; outcomes were measured at AMP Up 1‐year follow‐up. Separate robust Poisson regression models were used to assess associations of each factor with each outcome; PHIV status was explored as an effect modifier of each association. Results Participants (N = 315; YAPHIV = 228): 58% female, 67% Black and 27% Hispanic. Compared to YAPHEU, YAPHIV were older and from families with higher median income and fewer symptoms of parent/caregiver mental health/substance use disorders. Proportions of YAPHIV and YAPHEU, respectively, who achieved each milestone were comparable: 82% versus 78% for high school graduation (p = 0.49), 45% versus 51% for postsecondary education (p = 0.35) and 48% versus 54% for current employment (p = 0.32). Higher cognitive efficiency was positively associated with postsecondary education and current employment. Higher executive function, age‐appropriate behavioural/social‐emotional functioning and lower cumulative risk were associated with academic milestones. Among YAPHIV, positive associations were: higher current CD4 with postsecondary education and lower nadir CD4 with current employment. PHIV status did not modify any association. Conclusions YAPHIV and YAPHEU demonstrated resilience, attaining at least one young adult milestone. Cognitive, behavioural and social resources to support resilience in childhood and adolescence may provide the foundation for continued achievement throughout adulthood.

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Thirty-year Perspective of the Long-term Survival, CD4 Percentage and Social Achievements of Perinatally HIV-infected Children as a Function of Their Birth Era

Abstract: This first long-term follow-up study demonstrates remarkable survival and social skills of our patients.

Cited by 5 publications

References 8 publications

Behavioral Health and Adult Milestones in Young Adults With Perinatal HIV Infection or Exposure

Behavioral Health and Adult Milestones in Young Adults With Perinatal HIV Infection or Exposure

School functioning of children with perinatal HIV-infection in high-income countries: A systematic review

Ageing with HIV: a longitudinal study of markers of resilience in young adults with perinatal exposure to HIV, with or without perinatally acquired HIV

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