Impact of sociodemographic factors on cognitive function in school-aged HIV-infected Nigerian children

BACKGROUND In this study, we sought to evaluate the influence of sociodemographic factors, ie, age, sex, socioeconomic status, maternal education, and human immunodeficiency virus (HIV) status, on cognitive performance in school-aged HIV-infected Nigerian children. METHODS Sixty-nine HIV-positive children aged 6-15 years were matched with 69 HIV-negative control children for age and sex. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget's staging, ie, the concrete operational stage (6-11 years) and the formal operational stage (12-15 years). All participants underwent cognitive assessment using Raven's Standard Progressive Matrices (RPM). Sociodemographic data for the study participants, ie, age, sex, socioeconomic status, and level of maternal education, were obtained using a study proforma. Logistic regression analyses were used to determine associations of HIV status and sociodemographic characteristics with RPM cognitive scores. RESULTS The overall mean RPM score for the HIV-positive children was 18.2 ± 9.8 (range 8.0-47.0) which was significantly lower than the score of 27.2 ± 13.8 (range 8.0-52.0) for the HIV-negative children (P < 0.001). On RPM grading, 56.5% of the HIV-positive children had cognitive performance at below average to intellectually defective range. Below average RPM scores were found to be significantly associated with younger age (6-11 years), positive HIV status, lower socioeconomic status, and low level of maternal education. CONCLUSION Younger age, poor socioeconomic status, and low level of maternal education were factors apart from HIV infection that were significantly associated with low cognitive function in school-aged HIV-infected Nigerian children.