Abstract
Although HIV/AIDS is the 9th leading cause of death in African-American children, 80% of HIV-infected children in the U.S. live into school-age years. This study focuses on associations between HIV illness severity, family factors, and long-term cognitive functioning of these children. Participants included 42 perinatally HIV-infected children (mean age = 72.4 months), 93% of whom were African-American. Mean intellectual functioning was more than one standard deviation below the normative mean; whereas, overall language and attention functioning were generally not different from the normative sample. First, this study described changes in functioning over time and/or between genders. Analyses of variance were conducted for five outcome variables (i.e., full scale IQ, verbal IQ, performance IQ, expressive and receptive one word picture vocabulary test). Expressive language scores increased over time. For receptive language, males’ skills improved significantly over time, while the decline in females’ skills did not reach significance. Second, the associations between Time Two illness severity (i.e., viral load), and Time One familial variables (i.e., adult-to-child ratio in the home, number of caregivers lost to death, number of months since caregiver death), with outcome variables at Time Two (i.e., intellectual, language, and attentional/hyperactivity functioning) were examined. For intellectual and expressive language, only the respective Time One functioning independently contributed a significant amount to Time Two functioning. For receptive language, Time One receptive language and the adult-to-child ratio in the home significantly predicted Time Two functioning. As the number of adults per child increased, there was an improvement in receptive language functioning. For both measures of language, the interaction between Time Two illness severity and Time One months since caregiver death significantly predicted Time Two functioning. With no loss of caregiver, more ill children demonstrated better language abilities than less ill children. Across illness groups, children performed similarly after a recent caregiver death. With greater time since caregiver death, the less ill children performed better than their more ill peers. For attention/hyperactivity, no predictor variables were significant. Interventions that consider family factors, as well as medical information, as potential influences on future child functioning may aid in the battle against this chronic illness.
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