In utero/peripartum antiretroviral therapy exposure and mental health outcomes at 8–18 years old: A longitudinal comparative study of children with perinatally acquired HIV, children perinatally HIV exposed but uninfected, and children unexposed uninfected from Uganda

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dc.contributor.authorCoventry, Audrey
dc.contributor.authorSikorskii, Alla
dc.contributor.authorZalwango, Sarah K.
dc.contributor.authorFamiliar‐Lopez, Itziar
dc.contributor.authorCardino, Vanessa N.
dc.contributor.authorGiordani, Bruno
dc.contributor.authorEzeamama, Amara E.
dc.date.accessioned2024-04-04T08:54:41Z
dc.date.available2024-04-04T08:54:41Z
dc.date.issued2024-04
dc.description.abstractAbstract In utero/peripartum antiretroviral therapy (IPA) exposure type was examined in relationship to mental health symptoms among 577 children with perinatally acquired HIV (CPHIV), children perinatally HIV exposed but uninfected (CHEU), and children HIV unexposed uninfected (CHUU). IPA exposure was categorized for CPHIV and CHEU as none, single-dose nevirapine with or without zidovudine (sdNVP±AZT), sdNVP+AZT+lamivudine (3TC), or combination antiretroviral therapy (cART). Anxiety and depressive symptoms were reported at baseline, 6-, and 12-month follow-up per behavioral assessment system for children. Multivariable linear mixed models were used to estimate differences (b) with 95% confidence intervals (95% CI) for IPA exposure types versus CHEU without IPA exposure. Depressive and anxiety symptoms were lower in CHUU relative to CHEU and CPHIV but did not differ between CPHIV and CHEU. CHEU with sdNVP±AZT exposure had greater anxiety (b = 0.51, 95% CI: [0.06, 0.96]) and depressive symptoms (b = 0.48, 95% CI: [0.07, 0.89]) than CHEU without IPA exposure. CHEU with sdNVP+AZT+3TC exposure had higher anxiety (b = 0.0.45, 95% CI: [0.03, 0.86]) and depressive symptoms (b = 0.72, 95% CI: [0.27, 1.17]) versus CHEU without IPA exposure. Depressive and anxiety symptoms were not different for CHEU and CPHIV exposed to cART (b = 0.12-0.60, 95% CI: [-0.41, 1.30]) and CHEU and CHUU (b = -0.04 to 0.08, 95% CI: [-0.24, 0.29]) without IPA exposure. Among CHEU, peripartum sdNVP±AZT and sdNVP+AZT+3TC but not cART compared to no IPA exposure was associated with clinically important elevations in anxiety and depressive symptoms. Monitoring of mental health trajectory of HIV-affected children considering IPA is needed to inform mental health interventions. Patient Contribution: Caregivers and their dependents provided consent for participation and collaborated with study team to identify mutually convenient times for protocol implementation.en_US
dc.identifier.citationCoventry, Audrey, Alla Sikorskii, Sarah K. Zalwango, et al. 'In utero/peripartum Antiretroviral Therapy Exposure and Mental Health Outcomes at 8–18 Years Old: A Longitudinal Comparative Study of Children with Perinatally Acquired HIV, Children Perinatally HIV Exposed but Uninfected, and Children Unexposed Uninfected from Uganda', Research in Nursing & Health, vol. 47/no. 2, (2024), pp. 195-207.en_US
dc.identifier.issnISSN 0160-6891
dc.identifier.issnEISSN 1098-240X
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9468
dc.language.isoenen_US
dc.publisherWiley Subscription Services, Incen_US
dc.subjectantiretroviral therapy exposure, anxiety, children, depression, perinatal HIV statusen_US
dc.titleIn utero/peripartum antiretroviral therapy exposure and mental health outcomes at 8–18 years old: A longitudinal comparative study of children with perinatally acquired HIV, children perinatally HIV exposed but uninfected, and children unexposed uninfected from Ugandaen_US
dc.typeArticleen_US
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