The relationship between HIV and reading performance for children in Tanzania

Objective: Children with HIV (CWH) are at increased risk for cognitive and developmental delays, although HIV's influence on reading development remains unclear. Research using internationally validated reading measures with control for factors known to influence literacy outcomes is needed. The Early Grade Reading Assessment (EGRA) is a tool for assessing students' progress toward reading that has been validated across countries. It was administered to a cohort of children living with and without HIV (CWH/CWOH) and data on other factors that might affect literacy were also measured.

Design and methods: 388 children [217 children without HIV (CWOH) and 171 CWH; ages 3-8] drawn from a longitudinal study in Dar es Salaam, Tanzania completed the EGRA. EGRA performance between CWH and CWOH was compared adjusting for age, socioeconomic status, years of education, English learning, and type of school (public or private).

Results: Despite the biological and environmental confounders, CWH performed significantly worse than CWOH on the Letter Name Knowledge subtest, the Syllable subtest, the Non-Word subtest, and the Reading Comprehension subtest. The difference approached significance for the Oral Reading Fluency subtest.

Conclusions: CWH performed worse than CWOH on the EGRA, indicating literacy skill development in CWH needs early intervention. Longitudinal analyses, including electrophysiological and behavioral data, are needed to find the factors associated with poor reading and literacy performance in CWH.