HIV-Positive Children Are More Likely to Have Developmental Disabilities, New Study Shows

A new study on HIV-positive children in South Africa found they're more likely to have cognitive and physical delays than HIV-negative children.

HIV-positive kids, ages 4 to 6, were four times as likely as kids without HIV to experience sitting, walking, standing and speaking delays, according to a study by researchers from Columbia University's Mailman School of Public Health published in PLOS One. They were also twice as likely to have cognitive delays or hearing disabilities.

Of the 7 million people with HIV in South Africa, about 320,000 are children under the age of 14. While these numbers represent an improvement, according to the researchers, many children with HIV remain undiagnosed.

"There are fewer HIV-positive children, and there is more treatment available, but in resource-poor settings, there are still a number of children who are HIV-positive," Justin Knox, a postdoctoral fellow at Columbia and researcher on the study, told Newsweek. "How do we identify these children and what are the consequences of being HIV-positive?"

The researchers surveyed 14,425 households in KwaZulu-Natal, South Africa, identifying 2,049 children from those households. A widely used Ten Question screening was administered to the households, where parents reported on how their child functions compared with other children their age. This is the first time the Ten Question screening was administered in the Zulu language, which made it accessible to more families.

Additionally, a physician examined the children for developmental delays, without seeing the results of the Ten Question screening. The researchers found that 5 percent, or 62, of the children were HIV-positive—three times more than were known prior to the testing. "We were surprised at the number of undiagnosed HIV-positive children and at the high levels of disabilities even among HIV-negative children," Knox says.

The Ten Question screening reported that 43 percent of HIV-negative children and 59 percent of HIV-positive children showed developmental delays. These numbers were higher than expected, and the researchers believe they found these results because of the accessibility of the screening, due to the languages available and the social factors that were considered in writing the screening.

These results show that the screen could be an effective way to identify potential HIV-positive children. If parents report developmental delays on their Ten Question screening, then they could be encouraged to bring their child to a physician for further examinations and testing for HIV.

Knox explains that there is still more to discover. "One interesting avenue for research is whether or not these findings apply to HIV-negative children with HIV-positive mothers. Do they suffer from similar delays, or have they benefited from the prevention of transmission?"