Effects of perinatal HIV infection and early institutional rearing on physical and cognitive development of children in Ukraine

To study the effects of perinatal HIV-1 infection and early institutional rearing on the physical and cognitive development of children, 64 Ukrainian uninfected and HIV-infected institutionalized and family-reared chil-dren were examined (mean age 50.9 months). Both HIV infection and institutional care were related to delays in physical and cognitive development, with a larger effect of the rearing environment. Family care, even of compromised quality, was found to be more favorable for children’s physical and cognitive develop-ment than institutional care. The impact of the quality of child care on physical and cognitive development is discussed in light of future interventions. Early exposure to cumulative adversity may cause enduring neurobiological changes responsible for a range of developmental deficits in different domains (Nelson, 2007). The major sources of childhood adversity are poor health, economic hardship, and compromised rearing environment. The presence of perinatal HIV infection is associ-ated with all three of them: HIV, as a medical condition, has a direct impact on physical and cognitive development of the child; as a psycho-social phenomenon, pediatric HIV infection is usually accompanied by perinatal adversities, pov-erty, parental substance abuse and illness, and increased risk of child neglect, maltreatment an