In the antiretroviral era children perinatally infected with HIV (PHIV+) are surviving into adulthood and are at risk for emotional and behavioural problems. Few studies of these problems have been conducted in low and middle income countries (LMIC) and even fewer in sub - Saharan Africa where the burden of the HIV epidemic remains heaviest. The aims of this study were to provide a quantitative description of emotional and behavioural problems in a group of children and adolescents with perinatally acquired HIV in South Africa compared to a group of well - matched HIV - negative controls and to identify demographic, biological, cognitive and contextual correlates of emotional and behavioural problems. A cross-sectional descriptive, analytical study was conducted. Participants were recruited from community and hospital based clinics. Wi thin the HIV - infected group, children were further divided into three subgroups: PHIV+ children who had never been on antiretroviral therapy (ART naïve), PHIV+ children on ART and PHIV+ children on ART with a confirmed diagnosis of HIV - related encephalopathy (HIVE) . Emotional and behavioural problems were assessed using the Child Behaviour Checklist (CBCL). Several measures were used to assess demographic, biological, cognitive and contextual correlates of problem behaviours: socio - demographic questionnaire, clinic records, neuropsychological test battery, Family Resource Scale, Family Support Scale and Center for Epidemiologic Studies - Depression Scale. Children were compared by HIV status on demographic, cognitive and contextual variables as well as the total and subscale scores of the CBCL. Multivariate comparisons of the influence of contextual and cognitive variables on CBCL total problems was performed using a hierarchical step - wise linear regression analytic procedure. The final sample (N=108) for data analysis included 78 PHIV+ children and 30 HIV - negative children. Groups were comparable with respect to demographic and contextual variables. Cognitive performance scores were significantly lower in the PHIV+ children when compared to HIV - negative controls (p<0.001). Rates of caregiver depression were higher in both groups than the lifetime prevalence rates reported in the South African population.

Background: Hospital-based research provides important insight into the burden of suicide behaviour and methods used in deliberate self-harm (DSH). The information on methods used in DSH may be useful to plan suicide-related intervention and prevention programmes. We aimed to investigate the socio-demographic and clinical factors associated with the methods used in DSH at a tertiary hospital in Cape Town, South Africa. Methods: Socio-demographic, clinical and treatment data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Univariate analyses and a logistic regression model were used to explore the associations between these variables and violent and non-violent method of DSH. Results: Self-poisoning was the most common method of self-harm (80.3%, n=191). Prescription medication was the most common form of self-poison (57.6%, n=137) while a large number of patients used the non-prescription medication paracetamol (40.9%, n=54). In the bivariate regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH. Conclusion: This study contributes to emerging literature on methods used in DSH in South Africa. There is an urgent need to improve monitoring of prescription medication commonly used in DSH. More research on the source of prescription medication and its relationship to DSH is needed. Limiting the quantity and reviewing the packaging of paracetamol available in supermarkets may be effective strategies of means restriction that could be adopted in South Africa. This study underscores the need for increased collaboration between the Department of Social Development and the Department of Health in providing substance use interventions to high-risk population groups.