The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study
Background The intergenerational effects of HIV require long-term investigation. We compared developmental outcomes of different generations impacted by HIV—children of mothers not living with HIV, the ‘second generation’ (ie, with recently infected mothers) and the ‘third generation’ (ie, children...
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| Format: | Article |
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BMJ Publishing Group
2022-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/10/e058340.full |
| _version_ | 1811249837577863168 |
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| author | Lorraine Sherr Marguerite Marlow Nontokozo Langwenya Camille Wittesaele Elona Toska Katharina Haag Kathryn J Steventon Roberts Lucie Dale Cluver Bongiwe Saliwe Janke Tolmay Janina Jochim Wylene Saal Siyanai Zhou Jenny J Chen-Charles |
| author_facet | Lorraine Sherr Marguerite Marlow Nontokozo Langwenya Camille Wittesaele Elona Toska Katharina Haag Kathryn J Steventon Roberts Lucie Dale Cluver Bongiwe Saliwe Janke Tolmay Janina Jochim Wylene Saal Siyanai Zhou Jenny J Chen-Charles |
| author_sort | Lorraine Sherr |
| collection | DOAJ |
| description | Background The intergenerational effects of HIV require long-term investigation. We compared developmental outcomes of different generations impacted by HIV—children of mothers not living with HIV, the ‘second generation’ (ie, with recently infected mothers) and the ‘third generation’ (ie, children of perinatally infected mothers).Methods A cross-sectional community sample of N=1015 young mothers (12–25 years) and their first children (2–68 months, 48.2% female), from South Africa’s Eastern Cape Province. 71.3% (n=724) of children were born to mothers not living with HIV; 2.7% (n=27; 1 living with HIV) were third-generation and 26.0% (n=264; 11 living with HIV) second-generation children. Child scores on the Mullen Scales of Early Learning (MSEL), the WHO Ten Questions Screen for Disability and maternal demographics were compared between groups using χ2 tests and univariate approach, analysis of variance analysis. Hierarchical linear regressions investigated predictive effects of familial HIV infection patterns on child MSEL composite scores, controlling for demographic and family environment variables.Results Second-generation children performed poorer on gross (M=47.0, SD=13.1) and fine motor functioning (M=41.4, SD=15.2) and the MSEL composite score (M=90.6, SD=23.0) than children with non-infected mothers (gross motor: M=50.4, SD=12.3; fine motor: M=44.4, SD=14.1; composite score: M=94.1, SD=20.7). The third generation performed at similar levels to non-exposed children (gross motor: M=52.4, SD=16.1; fine motor: M=44.3, SD=16.1, composite score: M=94.7, SD=22.2), though analyses were underpowered for definite conclusions. Hierarchical regression analyses suggest marginal predictive effects of being second-generation child compared with having a mother not living with HIV (B=−3.3, 95% CI=−6.8 to 0 .1) on MSEL total scores, and non-significant predictive effects of being a third-generation child (B=1.1, 5% CI=−7.5 to 9.7) when controlling for covariates. No group differences were found for disability rates (26.9% third generation, 27.7% second generation, 26.2% non-exposed; χ2=0.02, p=0.90).Conclusion Recently infected mothers and their children may struggle due to the disruptiveness of new HIV diagnoses and incomplete access to care/support during pregnancy and early motherhood. Long-standing familial HIV infection may facilitate care pathways and coping, explaining similar cognitive development among not exposed and third-generation children. Targeted intervention and fast-tracking into services may improve maternal mental health and socioeconomic support. |
| first_indexed | 2024-04-12T15:54:36Z |
| format | Article |
| id | doaj.art-fe7dad3c84ec4c428d8c13d2bd639822 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T15:54:36Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj.art-fe7dad3c84ec4c428d8c13d2bd6398222022-12-22T03:26:25ZengBMJ Publishing GroupBMJ Open2044-60552022-10-01121010.1136/bmjopen-2021-058340The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional studyLorraine Sherr0Marguerite Marlow1Nontokozo Langwenya2Camille Wittesaele3Elona Toska4Katharina Haag5Kathryn J Steventon Roberts6Lucie Dale Cluver7Bongiwe Saliwe8Janke Tolmay9Janina Jochim10Wylene Saal11Siyanai Zhou12Jenny J Chen-Charles13Institute for Global Health, University College London, London, UKInstitute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Stellenbosch, Western Cape, South AfricaDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKNorwegian Institute for Public Health, Oslo, NorwayInstitute for Global Health, University College London, London, UKDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South AfricaCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South AfricaDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKSchool of Humanities, Sol Plaatje University, Kimberly, South AfricaCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South AfricaDepartment of Social Policy & Intervention, University of Oxford, Oxford, UKBackground The intergenerational effects of HIV require long-term investigation. We compared developmental outcomes of different generations impacted by HIV—children of mothers not living with HIV, the ‘second generation’ (ie, with recently infected mothers) and the ‘third generation’ (ie, children of perinatally infected mothers).Methods A cross-sectional community sample of N=1015 young mothers (12–25 years) and their first children (2–68 months, 48.2% female), from South Africa’s Eastern Cape Province. 71.3% (n=724) of children were born to mothers not living with HIV; 2.7% (n=27; 1 living with HIV) were third-generation and 26.0% (n=264; 11 living with HIV) second-generation children. Child scores on the Mullen Scales of Early Learning (MSEL), the WHO Ten Questions Screen for Disability and maternal demographics were compared between groups using χ2 tests and univariate approach, analysis of variance analysis. Hierarchical linear regressions investigated predictive effects of familial HIV infection patterns on child MSEL composite scores, controlling for demographic and family environment variables.Results Second-generation children performed poorer on gross (M=47.0, SD=13.1) and fine motor functioning (M=41.4, SD=15.2) and the MSEL composite score (M=90.6, SD=23.0) than children with non-infected mothers (gross motor: M=50.4, SD=12.3; fine motor: M=44.4, SD=14.1; composite score: M=94.1, SD=20.7). The third generation performed at similar levels to non-exposed children (gross motor: M=52.4, SD=16.1; fine motor: M=44.3, SD=16.1, composite score: M=94.7, SD=22.2), though analyses were underpowered for definite conclusions. Hierarchical regression analyses suggest marginal predictive effects of being second-generation child compared with having a mother not living with HIV (B=−3.3, 95% CI=−6.8 to 0 .1) on MSEL total scores, and non-significant predictive effects of being a third-generation child (B=1.1, 5% CI=−7.5 to 9.7) when controlling for covariates. No group differences were found for disability rates (26.9% third generation, 27.7% second generation, 26.2% non-exposed; χ2=0.02, p=0.90).Conclusion Recently infected mothers and their children may struggle due to the disruptiveness of new HIV diagnoses and incomplete access to care/support during pregnancy and early motherhood. Long-standing familial HIV infection may facilitate care pathways and coping, explaining similar cognitive development among not exposed and third-generation children. Targeted intervention and fast-tracking into services may improve maternal mental health and socioeconomic support.https://bmjopen.bmj.com/content/12/10/e058340.full |
| spellingShingle | Lorraine Sherr Marguerite Marlow Nontokozo Langwenya Camille Wittesaele Elona Toska Katharina Haag Kathryn J Steventon Roberts Lucie Dale Cluver Bongiwe Saliwe Janke Tolmay Janina Jochim Wylene Saal Siyanai Zhou Jenny J Chen-Charles The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study BMJ Open |
| title | The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study |
| title_full | The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study |
| title_fullStr | The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study |
| title_full_unstemmed | The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study |
| title_short | The development of children born to young mothers with no, first- or second-generation HIV acquisition in the Eastern Cape province, South Africa: a cross-sectional study |
| title_sort | development of children born to young mothers with no first or second generation hiv acquisition in the eastern cape province south africa a cross sectional study |
| url | https://bmjopen.bmj.com/content/12/10/e058340.full |
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