Neurologic aspects of HIV infection in infants and children: therapeutic approaches and outcome

Attention and concentration functions in HIV-positive adolescents who are on anti-retroviral treatment

It is generally agreed that patients either in the symptomatic stages of human immunodeficiency virus (HIV) infection or those in whom acquired immunodeficiency syndrome (AIDS) has already developed exhibit cognitive deficits. Specifically, attentional functioning has been investigated and found to be lowered in HIV-positive individuals compared to HIV-negative individuals. Medication regimen may also potentially confound the neuropsychological functioning. The intention of this study was to examine focused and divided attention in 30 adolescents between the ages of 13 and 16 years living with HIV who were commenced on managed anti-retroviral (ARV) programmes following diagnosis of HIV and immune compromise and compared to a contrast group of 71 HIV-negative adolescents. The results show that the mean number of errors on the Trail Making Test (TMT) Part B, as well as the mean time taken on Trials 1 and 3; the mean number of uncorrected errors on Trials 1 and 3; and the mean number of self-corrected errors on Trials 1, 2, and 3 of the Stroop Colour-Word Interference Test were significantly ( p < .05) higher in HIV-positive individuals compared to HIV-negative individuals.

Psychiatric considerations in children and adolescents with HIV/AIDS

The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

Psychiatric considerations in children and adolescents with HIV/AIDS

The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

Youths and HIV/AIDS: psychiatry's role in a changing epidemic

OBJECTIVE

To review the past 10 years of published research on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the United States, including psychosocial and psychiatric risk factors, epidemiology, biology, neurocognitive and psychiatric sequelae, disclosure issues, prevention strategies, and biological and behavioral treatments.

METHOD

Researchers reviewed the English-language literature with a focus on child and adolescent risk factors associated with HIV/AIDS, prevention, and treatment.

RESULTS

Substantial scientific advances have occurred over the past two decades leading to decreased morbidity and mortality in the United States from AIDS-related opportunistic infections. At the same time, rates of HIV infection are increasing in teenagers, young women, and minorities, and growing numbers of youths are living with an infected family member. Understanding HIV risk behavior requires a broad theoretical framework. Comprehensive HIV prevention programs have led to reduced risk behavior among HIV-affected youths and teens at risk of infection. Biological and behavioral treatments of HIV infection continue to evolve and have led to longer life span, improved quality of life, and fewer psychiatric problems.

CONCLUSIONS

HIV/AIDS has significant mental health implications, and psychiatry can play a critical role in curbing the epidemic. With minimal effort, mental health professionals can adapt and apply the strategies that they use to treat psychiatric symptoms to prevent HIV transmission behaviors.