Psychosocial functioning among HIV-affected youth and their parents/ caregivers in Haiti—implications for public health programs in high HIV burden settings

Objectives: The aims of the study were to: 1) describe the burden of psychiatric symptoms and degree of psychosocial functioning among HIV-affected youth and their parents/caregivers in central Haiti; and 2) examine the association between depressive symptoms in parents/caregivers and psychosocial outcomes among HIV-affected youth.

Methods: Baseline data from a study examining the feasibility of a psychosocial intervention for HIV-affected youth and their parents/caregivers were analyzed. For 492 participating youth, 330 caregivers participated since some families had more than one child enrolled. HIV-affected youth were recruited from Zanmi Lasante's catchment area in central Haiti. Inclusion criteria were: ages 10-17; had HIV-positive caregiver or parent had died from HIV; or youth was HIV-positive.

Results: HIV-affected youth demonstrated very high levels of anxiety, the most common symptoms reported were constant fidgeting (86%), headaches/stomachaches (84%), and restlessness (83%). Among their parents/caregivers, who were 89% HIV-positive, the most common depressive symptoms were feeling: low in energy (73%), everything is an effort (71%) and sadness (69%). Parents' level of depressive symptoms was associated with their children's overall symptom levels (OR=2.4; 95%CI:1.6-3.6) and their psychosocial functioning (OR=1.6; 95%CI:0.96-2.6) after controlling for confounding factors.

Conclusions: Public health interventions (e.g. HIV-prevention activities) targeting HIV-affected orphans and vulnerable children (OVC) should address their mental health status as well as their parents' level of depression. A family-focused approach integrating health/mental health services for HIV-affected youth may be beneficial for both the youth and their parents, particularly those who are HIV-positive and require adherence to daily antiretroviral regimens.