Stressful life events and their relationship to psychological and medical functioning in children and adolescents with HIV infection.

OBJECTIVES

To assess the relationship between number and type of stressful life events (SLEs) and psychological and medical functioning in HIV-infected children.

METHODS

For this cross-sectional study, caregivers of 55 vertically infected children aged 8-17 years completed a measure assessing SLEs occurring in the past 6 months. Children and caregivers both completed a questionnaire assessing the child's level of depression and anxiety. Concurrent demographic and medical data were gathered from chart review.

RESULTS

School-related SLEs were the most common type of event and predicted child-reported depressive symptoms. Children who had disclosed their diagnosis in the past 6 months were rated as more anxious by their caregivers than nondisclosers. Also, disclosers had lower CD4 percentages and absolute counts and higher viral load levels and were more likely to have been hospitalized recently. The total number of loss-related SLEs predicted viral load levels. Finally, children who experienced at least 1 financially related SLE had lower CD4 counts and were more likely to have been hospitalized than those experiencing no financial SLEs. Overall, children and caregivers reported nonsignificant levels of child depression and anxiety.

CONCLUSIONS

Both the total number and type of SLEs experienced have important implications for psychological and medical functioning in HIV-infected youth.