A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV Infected and HIV Exposed but Uninfected Urban Youths.
PURPOSE Significant gaps persist in our understanding of the etiological factors that shape the progression of mental health symptoms (MHS) among perinatally HIV infected (PHIV+ and perinatally HIV exposed but uninfected (PHEU) youths. This study sought to assess the changes in MHS among PHIV+ and PHEU youths as they transition through adolescence and to identify the associated psychosocial factors. METHODS Data were drawn from a longitudinal study of 166 PHIV+ and 114 PHEU youths (49% male, ages 9 16 years at baseline) in New York City. Individual interviews were administered at baseline and subsequently over a 5 year period. MHS were assessed using the youth version of the Diagnostic Interview Schedule for Children. Predictive growth curve analyses were conducted to assess longitudinal changes in MHS and identify the relevant factors. Level I predictors included: time, major life events, household poverty, caregiver mental health, and neighborhood stressors. Level II predictors included youths' sociodemographic characteristics (e.g. age, gender, HIV status) and baseline future orientation scores. RESULTS The changes in youths' MHS followed a quadratic growth curve and were positively associated with the number of major negative life events and neighborhood stressors experienced. Youths' HIV status, household poverty, and caregiver mental health were not significantly associated with youths' MHS. CONCLUSIONS Findings suggest that irrespective of youths' HIV status, major life events and neighborhood stressors increase MHS among PHIV+ and PHEU youths. There is a need for interventions to reduce the impact of stressors on the mental well being of PHIV+ and PHEU youths.
The Journal of adolescent health official publication of the Society for Adolescent Medicine