Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV

doi:10.1007/s10461-016-1508-5

. 2017 Sep;21(9):2703-2715.

doi: 10.1007/s10461-016-1508-5.

Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV

Katrina D Hermetet-Lindsay^{1

2

3}, Katharine F Correia⁴, Paige L Williams⁴, Renee Smith⁵, Kathleen M Malee⁶, Claude A Mellins⁷, Richard M Rutstein⁸; Pediatric HIV/AIDS Cohort Study

Affiliations

¹ Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. klindsay@chmca.org.
² Lehigh University School Psychology Program, Bethlehem, PA, USA. klindsay@chmca.org.
³ Division of Neurobehavioral Health, Akron Children's Hospital, 215 W. Bowery St. Suite 4500, Akron, OH, 44308-1062, USA. klindsay@chmca.org.
⁴ Department of Biostatistics, Harvard. T. H. Chan School of Public Health, Boston, MA, USA.
⁵ Department of Pediatrics, University of Illinois at Chicago Children's Hospital, Chicago, IL, USA.
⁶ Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁷ Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, USA.
⁸ Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

PMID: 27475941
PMCID: PMC5280576
DOI: 10.1007/s10461-016-1508-5

Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV

Katrina D Hermetet-Lindsay et al. AIDS Behav. 2017 Sep.

. 2017 Sep;21(9):2703-2715.

doi: 10.1007/s10461-016-1508-5.

Authors

Katrina D Hermetet-Lindsay^{1

2

3}, Katharine F Correia⁴, Paige L Williams⁴, Renee Smith⁵, Kathleen M Malee⁶, Claude A Mellins⁷, Richard M Rutstein⁸; Pediatric HIV/AIDS Cohort Study

Affiliations

¹ Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. klindsay@chmca.org.
² Lehigh University School Psychology Program, Bethlehem, PA, USA. klindsay@chmca.org.
³ Division of Neurobehavioral Health, Akron Children's Hospital, 215 W. Bowery St. Suite 4500, Akron, OH, 44308-1062, USA. klindsay@chmca.org.
⁴ Department of Biostatistics, Harvard. T. H. Chan School of Public Health, Boston, MA, USA.
⁵ Department of Pediatrics, University of Illinois at Chicago Children's Hospital, Chicago, IL, USA.
⁶ Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁷ Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, USA.
⁸ Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

PMID: 27475941
PMCID: PMC5280576
DOI: 10.1007/s10461-016-1508-5

Erratum in

Erratum to: Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV.
Hermetet-Lindsay KD, Correia KF, Williams PL, Smith R, Malee KM, Mellins CA, Rutstein RM; Pediatric HIV/AIDS Cohort Study. Hermetet-Lindsay KD, et al. AIDS Behav. 2017 Sep;21(9):2716. doi: 10.1007/s10461-016-1518-3. AIDS Behav. 2017. PMID: 27568337 No abstract available.

Abstract

Among perinatally HIV-infected (PHIV) and perinatally HIV-exposed, uninfected (PHEU) youth, we evaluated the contributions of home environment, psychosocial, and demographic factors and, among PHIV only, HIV disease severity and antiretroviral treatment (ART), to cognitive functioning (CF) and behavioral functioning (BF). A structural equation modeling (SEM) approach was utilized. Exploratory factor analysis was used to reduce predictor variables to major latent factors. SEMs were developed to measure associations between the latent factors and CF and BF outcomes. Participants included 231 PHIV and 151 PHEU youth (mean age = 10.9 years) enrolled in the PHACS adolescent master protocol. Youth and caregivers completed assessments of CF, BF, psychosocial factors and HIV health. Medical data were also collected. Clusters of predictors were identified, establishing four parsimonious SEMs: child-assessed and caregiver-assessed BF in PHIV and PHEU youth. Among both groups, higher caregiver-child stress predicted worse BF. Caregiver resources and two disease severity variables, late presenter and better past HIV health, were significant predictors of CF in PHIV youth. Higher youth CF was associated with better caregiver-reported BF in both groups. Caregiver resources predicted caregiver-reported BF in PHEU youth, which was mediated via youth CF. Among PHIV youth, better past HIV health and caregiver resources mediated the effects of CF on caregiver-assessed BF. Using SEMs, we found a deleterious impact of caregiver and child stress on BF in both groups and of HIV disease factors on the CF of PHIV youth, reinforcing the importance of early comprehensive intervention to reduce risks for impairment.

Keywords: Antiretroviral therapy; Behavior; Cognition; HIV; Structural equation models; Youth.

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Conflict of interest statement

Compliance with Ethical Standards: Conflict of Interest Katrina Hermetet-Lindsay, Katharine Correia, Paige Williams, Renee Smith, Kathleen Malee, Claude Mellins, and Richard Rutstein declare that they have no conflict of interest to report.

Figures

**Fig. 1**
Conceptual models post-EFA. a PHIV caregiver-assessed BF Model, b PHEU caregiver-assessed BF model

See this image and copyright information in PMC

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References

1. Smith R, Wilkins M. Perinatally acquired HIV infection: long-term neuropsychological consequences and challenges ahead. Child Neuropsychol. 2014;21:1–35. - PubMed
1. Mellins CA, Malee KM. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc. 2013;16:1–19. - PMC - PubMed
1. Koekkoek S, de Sonneville LM, Wolfs TF, Licht R, Geelen SP. Neurocognitive function profile in HIV-infected school-age children. Eur J Paediatr Neurol. 2008;12(4):290–7. - PubMed
1. Nichols S, Brummel SS, Smith RA, et al. Executive functioning in children and adolescents with perinatal HIV infection. [Accessed 9 Feb 2013];PIDJ. 2015 34:969–975. http://www.medscape.com/viewarticle/470017. - PMC - PubMed
1. Malee KM, Tassiopoulos K, Huo Y, et al. Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure. AIDS Care. 2011;23(12):1533–44. - PMC - PubMed

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[1] Smith R, Wilkins M. Perinatally acquired HIV infection: long-term neuropsychological consequences and challenges ahead. Child Neuropsychol. 2014;21:1–35. - PubMed

[2] Smith R, Wilkins M. Perinatally acquired HIV infection: long-term neuropsychological consequences and challenges ahead. Child Neuropsychol. 2014;21:1–35. - PubMed

[3] Mellins CA, Malee KM. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc. 2013;16:1–19. - PMC - PubMed

[4] Mellins CA, Malee KM. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc. 2013;16:1–19. - PMC - PubMed

[5] Koekkoek S, de Sonneville LM, Wolfs TF, Licht R, Geelen SP. Neurocognitive function profile in HIV-infected school-age children. Eur J Paediatr Neurol. 2008;12(4):290–7. - PubMed

[6] Koekkoek S, de Sonneville LM, Wolfs TF, Licht R, Geelen SP. Neurocognitive function profile in HIV-infected school-age children. Eur J Paediatr Neurol. 2008;12(4):290–7. - PubMed

[7] Nichols S, Brummel SS, Smith RA, et al. Executive functioning in children and adolescents with perinatal HIV infection. [Accessed 9 Feb 2013];PIDJ. 2015 34:969–975. http://www.medscape.com/viewarticle/470017. - PMC - PubMed

[8] Nichols S, Brummel SS, Smith RA, et al. Executive functioning in children and adolescents with perinatal HIV infection. [Accessed 9 Feb 2013];PIDJ. 2015 34:969–975. http://www.medscape.com/viewarticle/470017. - PMC - PubMed

[9] Malee KM, Tassiopoulos K, Huo Y, et al. Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure. AIDS Care. 2011;23(12):1533–44. - PMC - PubMed

[10] Malee KM, Tassiopoulos K, Huo Y, et al. Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure. AIDS Care. 2011;23(12):1533–44. - PMC - PubMed

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Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV

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Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV

Authors

Affiliations

Erratum in

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Conflict of interest statement

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