Effects of home environment, socioeconomic status, and health status on cognitive functioning in children with HIV-1 infection

Objective: To investigate the effects of the home environment, socioeconomi c status (SES), and health status on cognitive functioning in a sample of c hildren with HIV-1 infection in a cross-sectional study. Methods: Forty-three caregivers and their children (2.5 to 12 years) partic ipated. Caregivers completed two self-report measures of the home environme nt that included questions regarding the organization of the environment, p lay materials, parental involvement, variety of stimulation, and parental a ttitudes toward the provision of a cognitively stimulating environment. Cog nitive functioning was assessed using a standardized intelligence (IQ) test . Children's medical charts were reviewed for HIV-1 classification status ( CDC, 1994), CD4 cell counts, and current medication. Results: This study revealed two primary findings. First, measures of the h ome environment mediated the association between SES and child IQ. Second, measures of the home environment had a stronger association with child IQ d uring the advanced stages of disease than earlier stages of disease. Conclusions: The home environment is associated with cognitive functioning among children with HIV-1 infection. Moreover, interventions aimed at enhan cing the quality of the home environment may have a positive impact on thes e children's cognitive development.