Are there differences in child development and contextual factors between HIV-exposed and HIV-unexposed infant? A Brazilian interregional and cross-sectional study

Raissa Felipe Pádua; Cristina dos Santos Cardoso de Sá

doi:10.17267/2238-2704rpf.2026.e6408

Authors

Raissa Felipe Pádua Universidade Federal de São Paulo (São Paulo). São Paulo, Brasil. https://orcid.org/0000-0002-9674-3129
Cristina dos Santos Cardoso de Sá Escola Superior de Saúde do Alcoitão (Alcabideche). Alcabideche, Portugal. Sport Physical Activity and Health Research & Innovation Center (Coimbra). Coimbra, Portugal. https://orcid.org/0000-0002-0920-6668

DOI:

https://doi.org/10.17267/2238-2704rpf.2026.e6408

Keywords:

Child Development, Risk Factors, Infectious Disease Transmission, Vertical, HIV, Home Environment

Abstract

OBJECTIVE: This study aimed to compare motor, cognitive, and language development domains, as well as contextual and home environment factors, between HIV-exposed and HIV-unexposed infants from different Brazilian regions. METHODS: It is an observational cross-sectional study, with participation of 104 infants from the Southeast Region (Santos-SP) and 80 from the North Region (Belém and Benevides-PA), divided into two groups, namely HIV-exposed and HIV-unexposed. Assessment of infant development was by the Bayley-III Scale, the home environment was assessed using the Affordances in the Home Environment for Motor Development-Infant Scale, and the Brazilian Economic Classification Criteria was used for economic class evaluation. RESULTS: No significant differences were observed between HIV-exposed and HIV-unexposed infants in motor, cognitive, or language performance. However, significant regional differences were identified. Infants from the North region showed lower cognitive performance and fewer home environment affordances, particularly regarding stimulation variety, gross and fine-motor opportunities, and total affordance scores. Additionally, language development was associated with maternal age, and home environment affordances were associated with household type and fine-motor opportunities. The findings suggest that regional contextual factors, rather than HIV exposure alone, may play a more prominent role in early developmental outcomes. Social vulnerability and reduced environmental stimulation appear to be relevant contributors, reinforcing the importance of contextual interventions in early childhood.

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