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The researchers at Leiden University looked at 58 Ukrainian 4-year-old children, with and without human immunodeficiency virus. Some lived in institutions shortly after birth while others lived with their biological families.

The study, published in Child Development, found the quality of the relationships between the children and their caregivers had a bigger impact on children's physical growth and cognitive performance than the presence of the HIV infection or the quality of the physical environment. In addition, the study found for both children with and without HIV, even compromised family care was better for the children than institutional care.

The researchers say intervention efforts to help HIV-infected children should focus on improving caregiver-child relationships. The researchers suggest changing caregivers' working schedules so there is more stability and providing caregiver training to enhance the quality and sensitivity of care.

"This study underscores efforts to strengthen the quality of children's relationship with caregivers as important for children infected with HIV", the researchers said in a statement.

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