Mental health treatment patterns in perinatally HIV-infected youth and controls

Miriam Chernoff*, Sharon Nachman, Paige Williams, Pim Brouwers, Jerry Heston, Janice Hodge, Vinnie Di Poalo, Nagamah Sandra Deygoo, Kenneth D. Gadow, Sandra Burchett, Karin Nielsen, Nicole Falgout, Joseph Geffen, Jaime G. Deville, Audra Deveikis, Margaret Keller, Vicki Tepper, Ram Yogev, Diane Wara, Stephen A. SpectorLisa Stangl, Mary Caffery, Rolando Viani, Kreema Whitfield, Sunita Patil, Joan Wilson, Mary Jo Hassett, William Borkowsky, Sulachni Chandwani, Mona Rigaud, Andrew Wiznia, Lisa Frenkel, Patricia Emmanuel, Jorge Lujan Zilberman, Carina Rodriguez, Carolyn Graisbery, Roberto Posada, Mary S. Dolan, Midnela Acevedo-Flores, Lourdes Angeli, Milagros Gonzalez, Dalila Guzman, Warren A. Andiman, Leslie Hurst, Anne Murphy, Leonard Weiner, Denise Ferraro, Michele Kelly, Lorraine Rubino, Sohail Rana, Suad Kapetanovic, Mobeen H. Rathore, Ayesha Mirza, Kathleen Thoma, Chas Griggs, Robin McEvoy, Emily Barr, Suzanne Paul, Patricia Michalek, Ana Puga, Patricia Garvie, Richard Rutstein, Roberta LaGuerre, Murli Purswani, Mahrukh Bamji, Katherine Luzuriaga

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

BACKGROUND: Youths perinatally infected with HIV often receive psychotropic medication and behavioral treatment for emotional and behavioral symptoms. We describe patterns of intervention for HIV-positive youth and youth in a control group in the United States. METHODS: Three hundred nineteen HIV-positive youth and 256 controls, aged 6 to 17 years, enrolled in the International Maternal Adolescent AIDS Clinical Trials 1055, a prospective, 2-year observational study of psychiatric symptoms. One hundred seventy-four youth in the control group were perinatally exposed to HIV, and 82 youth were uninfected children living in households with HIV-positive members. Youth and their primary caregivers completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-referenced symptomrating scales. Children's medication and behavioral psychiatric intervention histories were collected at entry. We evaluated the association of past or current psychiatric treatment with HIV status, baseline symptoms, and impairment by using multiple logistic regression, controlling for potential confounders. RESULTS: HIV-positive youth and youth in the control group had a similar prevalence of psychiatric symptoms (61%) and impairment (14% to 15%). One hundred four (18%) participants received psychotropic medications (stimulants [14%], antidepressants [6%], and neuroleptic agents [4%]), and 127 (22%) received behavioral treatment. More HIV-positive youth than youth in the control group received psychotropic medication (23% vs 12%) and behavioral treatment (27% vs 17%). After adjusting for symptom class and confounders, HIV-positive children had twice the odds of children in the control group of having received stimulants and >4 times the odds of having received antidepressants. Caregiver-reported symptoms or impairment were associated with higher odds of intervention than reports by children alone. CONCLUSIONS: HIV-positive children are more likely to receive mental health interventions than control-group children. Pediatricians and caregivers should consider available mental health treatment options for all children living in families affected by HIV.

Original languageEnglish (US)
Pages (from-to)627-636
Number of pages10
JournalPediatrics
Volume124
Issue number2
DOIs
StatePublished - Aug 2009

Keywords

  • HIV
  • Psychiatric disorders
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Mental health treatment patterns in perinatally HIV-infected youth and controls'. Together they form a unique fingerprint.

Cite this