Modelling the long-term impacts on affected children of adult HIV: Benefits, challenges and a possible approach
Human and Social Development Research Programme, Human Sciences Research Council, 750 Francois Road, Durban, KwaZulu-Natal 4001, South Africa; South African Centre for Epidemiological Modelling and Analysis, South Africa; Department of Psychology, Stellenbosch University, Stellenbosch, South Africa; Steinhardt School of Culture, Education, and Human Development, New York University, NY, United States
We outline the benefits, challenges and possible approaches to developing mathematical models that could be used to estimate the magnitude of negative consequences of adult HIV infection for children. Adult HIV infection can lead to numerous negative consequences for dependent children, including depression, anxiety, withdrawal from school and early sexual debut, among others. For advocacy and planning purposes, it is important to highlight and consider as many of these as possible. A focus solely on orphan numbers, which is the typical summary measure for children affected by HIV and AIDS, can be misleading. The complexity of child development that is characterized by the interaction of a multitude of proximal and distal factors, coupled with a significant lack of data on child development in the context of adult HIV infection make the development of models a challenging task. Although it may not be possible in the first attempt to develop a population-based model capable of examining family dynamics, the negative consequences together with the impact of interventions, steps in that direction can be taken. We propose approaches and assumptions that we believe will allow the development of a useful first set of models. We conclude with a brief discussion of the type of data that, if collected, would facilitate refinement and development of these models. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
acquired immune deficiency syndrome; adult disease; anxiety; article; child development; child health; childhood disease; depression; disease course; environmental factor; human; Human immunodeficiency virus infection; incidence; maternal welfare; priority journal; risk factor; adult; child; child parent relation; family health; female; Human immunodeficiency virus infection; mental disease; preschool child; psychology; theoretical model; Adult; Child; Child, Preschool; Family Health; Female; HIV Infections; Humans; Mental Disorders; Models, Theoretical; Parent-Child Relations
USAID, National Research Foundation; National Research Foundation