Validation of the International Guide for Monitoring Child Development demonstrates good sensitivity and specificity in four diverse countries.

Aim: It is of critical importance to have internationally constructed tools to address early childhood development. The aim of this second phase of a two-phase study was to examine the sensitivity and specificity of the Guide for Monitoring Child Development (GMCD) in identifying developmental delay in four diverse countries.

Methods: The first phase of this 2011-2015 back-to-back study included 4949 children up to 42 months of age from primary healthcare centres in Argentina, India, South Africa and Turkey.

Similarities and differences in child development from birth to age 3 years by sex and across four countries: a cross-sectional, observational study.

Background: Knowledge about typical development is of fundamental importance for understanding and promoting child health and development. We aimed to ascertain when healthy children in four culturally and linguistically different countries attain developmental milestones and to identify similarities and differences across sexes and countries.

Methods: In this cross-sectional, observational study, we recruited children aged 0-42 months and their caregivers between March 3, 2011, and May 18, 2015, at 22 health clinics in Argentina, India, South Africa, and Turkey.

Early diagnosis is critical to ensure good outcomes in HIV-infected children: outlining barriers to care.

HIV-infected children require early initiation of antiretroviral therapy (ART) to ensure good outcomes. The aim was to investigate missed opportunities in childhood HIV diagnosis leading to delayed ART initiation. Baseline data were reviewed of all children aged <15 years referred over a 1-year period for ART initiation to the Kalafong Hospital HIV services in Gauteng, South Africa.

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa.

Objective: The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers.

Design/methods: HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers.

The role of parenting in affecting the behavior and adaptive functioning of young children of HIV-infected mothers in South Africa.

Prior investigations suggest that maternal HIV/AIDS poses significant challenges to young children. This study investigates the relationships between mothers' psychological functioning, parenting, and children's behavioral outcomes and functioning in a population of women living with HIV (N = 361) with a child between the ages of 6 and 10 years in Tshwane, South Africa. Utilizing path analysis, findings revealed that maternal depression is related to increased parenting stress and parent-child dysfunction, maternal coping is related to parenting style, and maternal coping, parenting style and stress, and parent-child dysfunction are associated with children's behavior and functioning, with parenting emerging as an important mediator.

Barriers to male-partner participation in programs to prevent mother-to-child HIV transmission in South Africa.

Efforts to prevent mother-to-child HIV transmission (PMTCT) in sub-Saharan Africa have focused overwhelmingly on women, to the unintended exclusion of their male partners. A cross-sectional study was conducted in Tshwane, South Africa, to determine barriers to male-partner participation during PMTCT. In-depth interviews were conducted with 124 men whose partners had recently been pregnant, and five focus group discussions were held with physicians, nurses, HIV counselors, and community representatives.

A pilot study using interactive SMS support groups to prevent mother-to-child HIV transmission in South Africa.

We investigated the feasibility of using mobile phone text messaging (SMS) to promote adherence to antiretroviral therapy among HIV-infected pregnant women recently diagnosed with HIV. Seven HIV-positive women (15-33 weeks gestation) from two urban antenatal clinics received mobile phones and were invited to use text messaging to discuss HIV, health and pregnancy over a 12-week period. All participants were connected to each other and to a clinician who guided the group and answered questions via group SMS messaging.

Where are the men? Targeting male partners in preventing mother-to-child HIV transmission.

Involvement of male partners may increase adherence to and improve outcomes of programs to prevent mother-to-child HIV transmission (PMTCT). Greater understanding of factors impeding male voluntary HIV counseling and testing (VCT) is needed. A cross-sectional study was conducted in Tshwane, South Africa.

Development of a measure of the patient-provider relationship in antenatal care and its importance in PMTCT.

The prevention of mother-to-child HIV transmission (PMTCT) is a complex challenge in heavily affected and resource-limited settings such as South Africa. Management of PMTCT requires a cascade of interventions that need to be addressed to effectively decrease the risk of HIV transmission to infants. This PMTCT cascade includes incremental components that can be shaped and influenced by the patient-provider relationship.

The impact of structured support groups for pregnant South African women recently diagnosed HIV positive.

The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006.

Factors affecting disclosure in South African HIV-positive pregnant women.

To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal al clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery.

To tell or not to tell: South African women's disclosure of HIV status during pregnancy.

HIV-positive pregnant women often do not disclose their serostatus to their partners, family and friends, creating potential barriers to preventing sexual transmission to partners and mother-to-child transmission through breastfeeding. This research explores recently diagnosed HIV-positive pregnant women's reasons for disclosure and non-disclosure of serostatus to various members of their social networks, as well as the consequences of their disclosure. Data were collected through open-ended questions as part of a semi-structured interview with 293 recently diagnosed HIV-positive pregnant women recruited from antenatal clinics in two townships in Tshwane, South Africa.

Development of parallel scales to measure HIV-related stigma.

HIV-related stigma is a multidimensional concept which has pervasive effects on the lives of HIV-infected people as well as serious consequences for the management of HIV/AIDS. In this research three parallel stigma scales were developed to assess personal views of stigma, stigma attributed to others, and internalised stigma experienced by HIV-infected individuals. The stigma scales were administered in two samples: a community sample of 1,077 respondents and 317 HIV-infected pregnant women recruited at clinics from the same community in Tshwane (South Africa).

The political path to mandatory prenatal HIV testing in Connecticut.

Editor's note: The study by Simpson and Forsyth published in this issue of JANAC is an evaluation of women's reactions to Connecticut Public Act 99-2, which established mandatory HIV testing for pregnant women in the state. Manuscript reviewers requested further information about the legislation. The authors provide an overview of the legislation in this commentary.

State-mandated HIV testing in Connecticut: personal perspectives of women found to be infected during pregnancy.

In the 5 years after the adoption of state-mandated HIV testing in Connecticut, 33% of HIV-positive pregnant women in the state were newly diagnosed during their pregnancy. Women who first learned that they were HIV-infected during pregnancy comprised of a unique group of people tested, in essence, by state mandate. A total of 11 such women agreed to in-depth interviews to share their personal perspectives regarding the benefits as well as the adverse sequelae of HIV testing for themselves, their children, and the public health.

Pediatricians' training and identification and management of psychosocial problems.

This study evaluated the association of pediatrician training on the identification and management of current and ongoing emotional or behavioral problems among children ages 4-8 years in 19 practices in south-central Connecticut. Pediatricians with advanced training in psychosocial issues were more likely to identify children's psychosocial problems and use multiple management strategies compared with pediatricians with no specialized training. Although pediatricians with moderate training in psychosocial issues were more likely to identify psychosocial problems compared with pediatricians with no training, there was no relationship between moderate training and management of psychosocial problems.

Rapid HIV testing of women in labor: too long a delay.

For HIV-infected women who have not received antiretroviral treatment or transmission prophylaxis in pregnancy, starting antiretrovirals in labor or soon after birth can still decrease the risk of perinatal transmission. There is, therefore, potential benefit in conducting rapid HIV testing in labor, but hospitals are seldom prepared to conduct such testing. We compared protocols for rapid HIV testing at 2 hospitals to determine what proportion of women had results back early enough to intervene if results had been positive.

Analyzing multiply matched cohort studies with two different comparison groups: application to pregnancy rates among HIV+ women.

We develop a new statistical method to analyze multiply matched cohort studies with two different comparison groups. We employ a linear-logistic model to describe the underlying log-odds ratios and use a conditional likelihood approach to conduct inference. Under the assumption of homogeneous log-odds ratios, we provide methods to construct both asymptotic and exact confidence regions of the two log-odds ratios in a simple case.

Pregnancy and birth rates among HIV-infected women in the United States: the confounding effects of illicit drug use.

Objective: To determine the effect of HIV infection on pregnancy and birth rates and assess the potentially confounding effect of illicit drug use.

Design: A retrospective record review of matched cohorts examining pregnancy outcomes for HIV-positive women and two HIV-negative comparison groups (one matched by drug use).

Methods: Ninety HIV-positive women who gave birth in a US city between 1989 and 1993 were matched to HIV-negative women by race, age, parity and date of index birth (group 1, N = 180) and also by the type of illicit drug used (group 2, N = 90).