Developmental outcomes of HIV-exposed infants in a low-income South African context

Abstract

Background: Effective Human Immunodeficiency Virus (HIV) transmission prevention strategies have led to a growing population of vulnerable HIV-exposed (HE) infants in sub-Saharan Africa, however uncertainty exists in literature regarding their developmental outcomes. Objective: The aim was to determine the developmental outcomes of six- to 12-month-old HE infants in a low-income South African context, when compared to HIV-unexposed (HU) counterparts. Method: In this prospective cross-sectional, group comparison study, the development of 41 HE and 40 HU infants (mean age = 8.4 months, SD = 2.1 months) from a low-income context was assessed. Caregivers were interviewed using a background interview and the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) to evaluate infants’ communication, daily living, socialisation and motor skills. Results: Based on the overall test scores, the majority of HE participants had age-appropriate development (90.2%; n=37). Some HE participants, however, presented with delays in the domains of communication (9.8%; n=4), daily living skills (2.4%; n=1), socialisation (19.5%; n=8) and motor development (7.3%; n=3). HU participants also demonstrated some domain-specific delays, thus delays were present in both groups. No statistically significant differences were found between the development of HE and HU participants. Conclusion: Findings were reassuring and suggested that the development of HE participants were similar to that of HU counterparts. Developmental differences may, however, only emerge with age, therefore large-scale longitudinal research is recommended. It is suggested that the entire sample was vulnerable, highlighting the importance of developmental surveillance and early intervention in low-income contexts, irrespective of HIV and antiretroviral exposure.