Conflict of interest statement: No conflicts declared.
Persisting mental health problems among AIDS-orphaned children in South Africa
Version of Record online: 30 AUG 2011
© 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Volume 53, Issue 4, pages 363–370, April 2012
How to Cite
Cluver, L. D., Orkin, M., Gardner, F. and Boyes, M. E. (2012), Persisting mental health problems among AIDS-orphaned children in South Africa. Journal of Child Psychology and Psychiatry, 53: 363–370. doi: 10.1111/j.1469-7610.2011.02459.x
- Issue online: 13 FEB 2012
- Version of Record online: 30 AUG 2011
- Accepted for publication: 11 July 2011 Published online: 30 August 2011
- post-traumatic stress
Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world.
Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children (M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression.
Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans.
Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children.