By: Joann Schulte, DO, MPH
|Photo by Julien Harneis via Flickr|
Every pediatric practice has such children: She might be an older sister of an ex-preemie who gets short shrift of maternal time because her mother spends much of the week taking the infant to an endless series of medical appointments. Maybe he is the 5-year-old who had a kidney transplant and now seems to do nothing but fight with the younger brother who was once his constant companion.
Chronic medical conditions impact siblings and families. So it is not surprising that the stigma of HIV influences not only the children and adults who are infected with the virus, but also children who are affected by HIV, but not infected themselves.
The topic was explored in a study published in the August issue of Pediatrics and studied children aged 10 to 17 years in Rwanda. Betancourt et al. (doi: 10.1542/ peds.2013-2734) found HIV-affected children were more likely to be depressed, anxious and have conduct problems than their counterparts who were either HIV-infected or HIV-negative.
Researchers enrolled 683 children of whom 218 were HIV-infected, 228 HIV-affected (negative for HIV but with family members infected) and 237 were HIV-unaffected (HIV negative and no family members infected). The study was a collaboration between faculty at the Harvard School of Public Health, the Rwandan Ministry of Health and Partner in Health, a Boston-based NGO.
What does this mean for you? The healthy children in your practice whose siblings have chronic illness have their counterparts in Rwanda. Dealing with mental health is an issue, no matter what chronic illnesses impact children or what language they speak.