The effect of environment and in-utero HIV exposure on neurodevelopment in infants

There were 643 children with 24-month outcome data, 49% of which were CHEU. Three latent factors were identified for neurodevelopment: Language, Executive Function, and Child Development. The factors did not correlate closely with each other and had different biological and environmental drivers. Quality of mother-child interactions was the strongest predictor of Child Development ( P < 0.001) and maternal mental health was a strong predictor of Executive Function ( P < 0.001). Despite adjustment for all environmental variables, CHEUs had lower Child Development scores than CHUU ( P = 0.01).Conclusion: Developmental scores of CHEU were lower than those of CHUU despite high maternal ART use, after accounting for postnatal environment. Despite this, the impact of high-quality maternal-child interactions on child development outweighed the impact of HIV exposure on neurodevelopment in this population.