Psychological Maladjustment of Children Living with HIV Versus Healthy Controls: A Cross-sectional Approach of Association with Sociodemographic and Clinical Variables

Abstract

Background: Children Living with HIV (CLWH) have adverse events, including predisposition to Psychological Maladjustment (PM), which may impair functional abilities. It is imperative to determine the factors that predispose to PM, as some of these factors may be modifiable, enabling timely interventions. However, there are gaps in knowledge regarding these factors, particularly in low-resource settings. Objectives: To determine the sociodemographic and clinical factors associated with PM among CLWH in Umuahia. Materials and methods: A cross-sectional analytical study of 386 participants comprising 193 CLWH and 193 healthy controls. Their sociodemographic and clinical variables were obtained, and PM was determined using the Strengths and Difficulties Questionnaire. Results: The CLWH had a significantly higher PM burden than the controls. Factors associated with PM in the CLWH were the CLWHs’ age, sex, Socioeconomic Class (SEC), orphan status, relationship with their caregivers, and caregivers’ marital status. Those aged 14/15 years (AOR=4.92, P=0.035), females (AOR=2.76, P=0.023), double-orphaned (AOR=11.12, P=0.032), belonging to the middle (AOR=4.18, P=0.018) and lower (AOR=4.69, P=0.004) SECs were five, three, 11, four and five times more likely to have PM, respectively. Also, those residing with non-biological (AOR=3.2, P=0.010), divorced (AOR=8.16, P=0.001), and widowed (AOR=6.91, P=0.016) caregivers were three, eight, and seven times more likely to have PM, respectively. Conclusion: There is a high PM burden among CLWH. Factors associated with this include CLWH’s age, sex, SEC, orphan status, relationship with their caregivers, and caregivers’ marital status. The strongest association was with double-orphans and residing with widowed or divorced caregivers.