AUTHOR=Lentoor Antonio G. 

TITLE=The Association of Home Environment and Caregiver Factors With Neurocognitive Function in Pre-school- and School-Aged Perinatally Acquired HIV-Positive Children on cART in South Africa

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 7 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00077

DOI=10.3389/fped.2019.00077

ISSN=2296-2360

ABSTRACT=Background: Children with perinatally acquired HIV in low resource settings are at an increased risk for neurocognitive impairments not only due to the direct effects of HIV on the brain and in utero ART exposure but also due to factors associated with their environment. Thus, the aim of this study was to assess the influence of home environment and caregiver factors on the neurocognitive functioning of pre-school-and-school-aged HIV-positive South African children from low resource rural communities. 
Methods and Materials: The Wechsler Preschool and Primary Scale of Intelligence-III was administered to assess the neurocognitive functioning of 152 purposively sampled perinatally acquired HIV-positive children on cART, aged 3 years to 7 years 6 months (mean age 63.13 months). The primary caregivers (n= 152) completed the Home Screening Questionnaire to assess the quality of the home environment of the children.
Results: A large percentage (>70%) of the children presented with below the average global neurocognitive functioning (FSIQ) (M= 81.47, SD=12.81). The results showed that aspects of the home environment is associated with the neurocognitive development of perinatally HIV-positive children on cART. Most of the HIV-positive children (n = 95) were under the care of an extended relative. Older HIV-positive boys, reared by biological mothers, who also lived in suboptimal and poor quality home environments had poorer neurocognitive function when compared to HIV-positive children reared by non-biological (extended relatives) caregivers, F (2,149) = 14.42, p<0.001. 
Conclusion: The child’s early home environment is associated with general neurocognitive development, with greater risk for poorer outcomes observed in HIV-positive children living with biological caregivers than extended relatives, in impoverished settings.