Factors associated with anxiety in children and adolescents with HIV infection

Introduction
Children and adolescents with human immunodeficiency virus (HIV) infection, usually have several complex problems, both biological and psychiatric. This study aimed to investigate factors associated with anxiety in children and adolescents with HIV.

Material and methods
This cross-sectional study was conducted at allergy-immunology outpatient clinic in Sanglah Hospital, Denpasar, Indonesia. A total of 60 children and adolescents aged 7-18 years were assessed using Spence children’s anxiety scale to detect anxiety. Associated factors included age, gender, orphan status, primary caregiver, clinical stage, CD4+ count, hospitalization, and disclosure status. Statistical analysis was performed using χ2 test, followed by multivariate analysis with binary logistic regression. P-value less than 0.05 was considered significant.

Results
Elevated anxiety symptoms were found in 22 subjects (36.7%) in the form of separation anxiety symptoms (72.7%), obsessive-compulsive disorder (50.0%), physical injury fear (45.5%), panic- agoraphobia (36.3%), social phobia (27.2%), and generalized anxiety disorder (22.7%). In multivariate analysis, older age (PR: 6.91; 95% CI: 1.55-30.89%) and orphan status (PR: 9.56; 95% CI: 1.12-81.89%) were independently associated with elevated anxiety symptoms.

Conclusions
Elevated anxiety symptoms were prevalent among HIV-infected children and adolescents, primarily in the form of separation anxiety. Older age and orphan status were independently associated with elevated anxiety symptoms.