Evidence-based gender findings for children affected by HIV and AIDS – a systematic overview

Figures & data

Table 1. Gender findings on systematic review of impact of HIV on schooling.

Study	Country	Sample	Control group	Gender description Yes/No Child/Parent	Analysed by gender effects Yes/No Child/Parent	Child gender findings	Death of parent gender findings	Child and parent gender interaction
Ainsworth, Beegle, and Koda (2005)	Tanzania	Kagera health and development survey – longitudinal survey from 1991 to 1994. About 757 households completed all rounds. Sixty-two primary schools	Non-orphans	Y Child Parent	Y Child Parent	Female negative effect on hours of attendance	Maternal death Negative effect on enrolment and attendance	Female maternal, female double orphans Negative effect on hours of attendance
Akresh (2004)	Burkina Faso	Survey of 606 household heads and their 812 wives. About 300 paired households that had exchanged a foster child between 1998 and 2000	Siblings	N	N	–	–	–
Bennell (2005)	Uganda, Malawi, Botswana	Review and analysis of empirical studies, DHS surveys	Non-orphans	See below
	Botswana			Y Parent	Y Parent	–	Maternal death Negative effect on repeating grade and dropping out Double parental death Negative effect on dropping out, positive effect on attendance	–
	Uganda			Y Parent	Y Parent	–	Maternal death Negative effect on dropping out Paternal death Negative effect on repeating grade. Double death negative effect on dropping out positive effect on attendance	–
	Malawi			Y Child Parent	Y Child Parent	None independent of parental gender	Maternal death Negative effect on repeating grade	Female paternal orphans, male double orphans Negative effect on dropping out. Female paternal/double negative effect on attendance
Bhargava (2005)	Ethiopia	The National Survey of Prevalence and Characteristics of Orphans in Ethiopia (2001—2002). (MMPI), ∼1000 orphans completed inventory	Non-AIDS orphans	Y Child Maternal death	Y Child	Female Negative effect on participation	–	–
Bicego, Rutstein, and Johnson (2003)	Zimbabwe Kenya, Tanzania, Ghana, Niger	DHS surveys 1995–2000	Non-orphans	Y Parent	Y Parent	–	Maternal and double parent death Negative effect on correct grade level	–
Case and Ardington (2005)	South Africa	Longitudinal data from a demographic surveillance area office. HSE surveys. ∼20,000 children	Non-orphans	Y Child Parent	Y Child Parent	No gender difference on any measure of schooling	Maternal and double parent death Negative effect on enrolment, years completed money spent on education	No interaction
Case, Paxson, and Ableidinger (2004)	Ten sub-Saharan Africa	Nineteen DHS studies (Ghana, Kenya, Malawi, Mozambique, Namibia, Niger, Tanzania, Uganda, Zambia, Zimbabwe)	Non-orphans	Y Child Parent	Y Child Parent	No gender difference on any measure of schooling	No gender difference Negative effect on enrolment for all orphans	No interaction
Chatterji, et al. (2005)	Rwanda Zambia	Zambia: 496 primary caregivers, 504 children, 563 adolescents Rwanda: 570 primary caregivers 656 children, 402 adolescents	Y	Y Child Parent	N	–	–	–
Evans and Miguel (2007)	Kenya	About 7815 children with completed questionnaire data and parental mortality data	Y Non-orphans	Y Child Parent	Y Child Parent	No gender difference	Maternal death Negative effect on participation	No interaction
Kamali et al. (1996)	Uganda	Rural population cohort 10,000 people 52% under 15 yrs. Demographic, socio-economic, serological surveys	Y Non-orphans	Y Parent	N	–	–	–
Mishra et al. (2005)	Kenya	The 2003 KDHS. About 9865 households. Population-based nationally –representative surveys link individual HIV test results	Y HIV+ parents HIV- parents	Y Child Parent	Y Child Parent	Female Negative effect on attendance	Maternal death, paternal death Negative effect attendance Double positive effect on attendance vs. single orphans	Not detailed
Monasch and Boerma (2004)	Forty sun-Saharan Africa	Twenty-three MICS surveys Fourteen DHS surveys	Y Non-orphans	Y Child Parent	Y Child Parent	No gender difference On attendance	Double parental death Negative effect on attendance	No interaction No difference maternal or paternal orphans, boys or girls
Nyamukapa and Gregson (2005)	Zimbabwe	First round data from Manicaland study. About 8399households About 2402 children of primary school completion age.	Y Non-orphans	Y Child Parent	Y Child Parent	Male negative effect on completion rate	Maternal death Negative effect on completion rate Paternal death Positive effect on completion rate	Female paternal orphans Positive effect on completion compared with non-orphans
Sharma (2006)	Malawi	Longitudinal. Five rounds between 2000 and 2004. Five hundred and thirty-four rural households	Y Non-orphans	Y Child Parent	Y Child Parent	Female Negative effect on dropping out	No gender difference Negative effect on dropping out for all orphans	No interaction
Yamano and Jayne (2005)	Kenya	Three-year panel of rural household surveys. About 1266 households included in all three surveys.	Y Children No adult mortality	Y Child	Y Child	Female Negative before death Male Negative after death	–	–
Notes: DHS = Demographic & Health Surveys; HSE = Household Socio-Economic; KDHS = Kenya Demographic & Health Survey; MICS = Multiple Indicator Cluster Survey; C-SAFE = Consortium for Southern Africa Food Emergency; WFP = World Food Program; OVC = orphans and vulnerable children; PWH = parents with HIV/AIDS; STI = sexually transmitted infection

Table 2. Gender findings on systematic review of the effects of HIV on nutrition.

Study	Country	Sample	Control group	Gender Yes/No Child/Parent	Analysed by gender Yes/No Child/Parent	Child gender findings	Death of parent gender findings	Child and parent gender interaction
Bhargava (2005)	Ethiopia	National orphans in Ethiopia (2001–2002), ∼1000	Non-orphans and non-AIDS orphans	Y Child Parent (Maternal death only)	N	–	–	–
Bridge, Kipp, Jhangri, Laing, and Konde-Lule (2006)	Uganda	Cross-sectional, questionnaire and anthropometric measures About 205 homes sampled	Children from non-AIDS affected households	Y Child Parent	Y Child Parent	No gender difference	No gender difference No negative effect for orphans on nutritional status	No interaction
Chatterji et al. (2005)	Rwanda and Zambia	Zambia: 496 primary caregivers 504 children, 563 adolescents Rwanda: 570 primary caregivers, 656 children, 402 adolescents	Orphans compared with vulnerable children Other children	Y Child Parent	N	–	–	–
Crampin et al. (2003)	Malawi	Population survey About 1106 children included	Non-orphans	Y Parent	N	–	–	–
Kamali et al (1996)	Uganda	Rural population cohort 10,000, 52% <15 yrs	Non-orphans	Y Parent	N	–	–	–
Lindblade, Odhiambo, Rosen, and DeCock (2003)	Kenya	1999 with follow up in 2000, 1347 children at baseline, 78.3% follow-up.	Non-orphans	Y Child Parent	Y Child Parent	No gender difference On health and nutritional status	Paternal death Negative effect on malnourishment	No interaction
Masmas et al. (2004a)	Guinea-Bissau	Approximately 1100 interviews (300 case children, 800 non-orphan controls)	Non-orphans	Y Child Parent (Maternal)	Y Child	No gender difference On nutritional status	–	–
Masmas et al. (2004b)	Guinea-Bissau	Approximately 1100 interviews (300 case children, 800 non-orphan controls)	Non-orphans	Y Child Parent (Maternal death only)	Y Child	No gender difference On mortality	–	–
Mishra et al. (2005)	Kenya	The 2003 KDHS About 9865 households	Positive and negative parents	Y Child Parent	Y Child (Sample size too small)	Male Negative effect on stunting, being underweight and wasting	–	–
Panpanich, Brabin, Gonani, and Graham (1999)	Malawi	Cross-sectional study (76 orphanage children, 137 village orphans, 80 village non-orphans)	Non-orphans	Y Child	Y Child	Female – in orphanages Negative effect on malnourishment No gender effect – village orphans	Maternal deathNegative effect on malnourishment	–
Rivers, Silvestre, and Mason (2004)	Botswana Uganda Malawi	Analysis of: 30 DHS and MICS II surveys, two sub-national UNICEF surveys, six C-SAFE/WFP	Non-orphans	Y Child Parent	Y Child (Sample sizes small)	No gender difference On health and nutritional status	–	–
Ryder, Kamenga, Nkusu, Batter, and Heyward (1994)	Zaire	About 466 HIV + women, their children and fathers About 606 HIV- women, their children and the fathers	HIV- women and families	N	N	–	–	–
Sarker, Neckermann, and Muller (2005)	Uganda	Cross-sectional survey (241 orphans, 278 non-orphan controls)	Non-orphans	Y Child Parent	Y Child	No gender difference On health status	–	–
Watts et al. (2007)	Zimbabwe	Analysis of data from ∼30,000 children	Non-orphans	Y Child Parent	Y Child Parent	No gender difference On heath and nutritional status	Maternal death Heightened risk of stunting and being underweight Paternal death Heightened risk of stunting Double parental death heightened risk of being underweight	No interaction
Notes: DHS = Demographic & Health Surveys; HSE = Household Socio-Economic; KDHS = Kenya Demographic & Health Survey; MICS = Multiple Indicator Cluster Survey; C-SAFE = Consortium for Southern Africa Food Emergency; WFP = World Food Program; OVC = orphans and vulnerable children; PWH = parents with HIV/AIDS; STI = sexually transmitted infection

Table 3. Gender findings for systematic review of studies on the effect of HIV and bereavement.

Study	Country	Sample	Control Group Yes/No	Gender Yes/No Child/Parent	Analysed by gender Yes/No Child/Parent	Child Gender findings	Death of Parent Gender findings	Child and Parent gender interaction
Atwine, Cantor-Graae, and Bajunirwe (2005)	Uganda	11–15 yrs 123 case children (parent(s) died of AIDS), 110 controls	Non-orphans	Child Parent	Y Child Parent	No gender difference on psychological distress measures	No gender difference On psychological distress (orphans higher distress)	No interaction
Bhargava (2005)	Ethiopia	The National Survey Orphans in Ethiopia (2001–2002) Approximately 1000	Non-orphans and non-AIDS	Y Child Parent (Maternal death)	Y Child	Female Negative effect on emotional adjustment and social adjustment	–	–
Cluver and Gardner (2006)	South Africa	6–19 yrs Thirty case/30 matched controls	Non-orphans	Y Child	Y Child	No gender differences On psychological well-being	–	–
Dowdney et al. (1999)	UK	2–16 yrs Sixteen boys, 29 girls matched controls	Y	Y Child Parent	Y Child Parent	Male Negative effect on externalising scores, and total problem scores	No gender difference Psychological disturbance scores	No interaction
Forehand et al. (1999)	USA	6–11 yrs 20 case children 40 controls	Y	Y maternal death	N	–	–	–
Gregson et al. (2005)	Zimbabwe	15–18 yrs About 1523 teenagers population survey	Non-OVC	Y Child Parent	Y Child Parent	Female Increased risk of HIV infection, STI symptoms and teenage pregnancy	Maternal death Increased sex and marriage, no secondary school education, poor reproductive health.	Female maternal orphans Increased risk HIV poor reproductive health, commencement of sex and marriage, no secondary school
Lee, Detels, Rotherham-Borus, and Duan (2007)	USA	11–18 yrs About 206 adolescents with PWH intervention, 207 control group	Y	Y Child Parent	Y Child	Male Increased risk of depression	–	–
Lester et al. (2006)	USA	12–18 yrs About 423 adolescents intervention vs. no intervention	Y	Y Child Parent	Y Child	Female increased risk of depression	–	–
Makame, Ani, and Grantham-McGregor (2002)	Tanzania	10–14 yrs Forty-one AIDS orphans, 41 controls	Y	Y Child	Y Child	Female negative effect on internalising problems	–	–
Operario, Pettifor, Cluver, MacPhail, and Rees (2007)	South Africa	15–24 yrs About 11,904 cases national survey	Y	Y Child Parent	Y Child	Female Increased risk of HIV infection, commencement of sex and multiple partners Male Increased risk of unprotected sex	–	–
Rotherham-Borus, Stein, and Lester (2006)	USA	11–18 yrs Longitudinal 6 year study, 288 (intervention vs. no intervention)	Y	Y Child Parent	Y Child	Female Increased risk of emotional distress Male Increased substance	-	-
Rotherham-Borus, Weiss, Alber, and Lester (2005)	USA	11–18 yrs Ssix year study About 414 adolescents	Y	Y Child Parent	Y Child	No gender difference On psychosocial adjustment	–	–
Sengendo, and Nambi (1997)	Uganda	About 172 orphans (6–20 yrs), 24 controls	Y	Y Parent	Y Parent	–	Maternal death Increased risk of depression	–
Wolchik, Tein, Sandler, and Ayers (2006)	USA	Mean age 11.46, 339 cases longitudinal	Y	Y Child	Y Child	Female Negative effect on fear of abandonment, internalising problems and self-esteem	–	–
Wood, Chase, and Aggleton (2006)	Zimbabwe	7–22 yrs Fifty-six OVC, 41 adults	N	N	N	–	–	–

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