Objectives: After active antiretroviral therapy, children with HIV are clinically well, whereas psychosocial issues continue to influence their quality of life. The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization evaluates health status and environmental and social factors associated with health. We investigated the efficacy of the ICF to describe the health status and needs of a cohort of children and adolescents with HIV seen at a reference center for pediatric AIDS in Europe.
Methods: A quantitative analysis of structured interviews was performed. Caregivers of children and adolescents with HIV infection in follow-up at 2 reference centers for pediatric AIDS were enrolled. Four major areas included in the ICF instrument were investigated: impairments of body structures; impairments of body functions; environmental factors; and activity limitations and restrictions to social life.
Results: Forty-one families of children with HIV were enrolled. Body structures and functions were marginally impaired, whereas environmental factors and psychosocial issues had a relevant impact on quality of life. Most families considered environmental factors to be “barriers”; these were poverty, unemployment, and single-parent family structure. Activity limitations and social restrictions were also reported in a few cases. Almost all parents reported problems in disclosing their child's HIV status because of the fear of social stigma.
Conclusion: Psychosocial issues are part of the well-being of children with HIV. The ICF is a standard tool to evaluate the clinical and psychosocial status of children and adolescents with HIV infection and to measure the impact of therapeutic interventions and strategies on psychosocial functioning.
From the *Department of Pediatrics, University “Federico II,” Naples, Italy; †Clinica Pediatrica and Scienze Biomediche e Biotecnologie, University of Brescia, Brescia, Italy.
Received February 2010; accepted July 2010.
Alfredo Guarino had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
The research was supported by a grant from the television company Sky Italia S.r.l, which provided an unrestricted grant that contributed, in part, to the support of the psychologist administering the structured interviews.
Address for reprints: Alfredo Guarino, MD, Department of Pediatrics, University “Federico II,” Via S. Pansini 5, Naples 80131, Italy; e-mail: firstname.lastname@example.org.