Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in South Africa

Figures & data

Table 1. Baseline characteristics of the children aged 10–17 by program model.

	Total sample	Volunteer driven	Paraprofessional	p-Value of t statistic or χ^2
Child
Age (mean)	13.60	13.59	13.61	.866
Female (%)	52	51	52
Orphan status				.000***
Maternal orphan	11	10	14
Paternal orphan	26	33	16
Double orphan	49	37	67
Relationship to caregiver				.000***
Parent	29	39	13
Grandparent/aunt/uncle	58	59	72
Sibling	11	9	13
Other	3	3	2
Caregiver
Age (mean)	48.63	46.78	51.34	.000***
Female (%)	93	92	95	.014**
Married or living as married (%)	20	21	17	.099
Has some education (%)	69	70	66	.164
Household
Ill household member (%)	43	44	42	.408
Dependency ratio (mean)
Poverty^† (%)				.194
Less than 1000R a month	81	82	79
1000–2500R a month	17	15	19
>2500R a month	2	2	2
Peri-urban (%)	13	18	6	.000***
N	1487	894	593

** p ≤ 0.01; ***p ≤ 0.001; ^†Exchange rate was approximately $1 = 7.5 Rand (R) at the time of this study, 1000R = $130.

Table 2. Psychological health of children and caregivers by round and program model.

	Total		Volunteer driven		Paraprofessional
	Baseline (%)	Follow-up (%)	Baseline (%)	Follow-up (%)	Baseline (%)	Follow-up (%)
Child – girls
Depressive symptomology	18	23	20	25	14	22
Behavioral problems	29	35	31	39	26	29
Child – boys
Depressive symptomology	16	22	18	24	13	19
Behavioral problems	28	43	31	43	24	42
Caregiver
Negative feelings	41	35	44	33	36	37
Poor family functioning	30	59	37	64	20	52

Table 3. Multivariate models of high levels of psychological problems among children.

	Girls		Boys
	Depressive symptomology	Behavioral problems	Depressive symptomology	Behavioral problems
	OR (CI)	OR (CI)	OR (CI)	OR (CI)
Paraprofessional model	0.76 (0.49–1.18)	0.75 (0.51–1.12)	0.83 (0.52–1.34)	0.73 (0.50–1.15)
Round	1.01 (0.70–1.48)	1.63** (1.14–2.31)	1.58* (1.07–2.33)	2.17*** (1.49–3.15)
Paraprofessional*Round	1.33 (0.75–2.35)	0.96 (0.58–1.60)	0.98 (0.54–1.80)	1.38 (0.80–2.37)
Age of child	1.07* (1.00–1.15)	1.01 (0.95–1.08)	1.03 (0.95–1.11)	0.99 (0.92–1.06)
Orphan status
Maternal orphan	0.87 (0.48–1.59)	0.81 (0.46–1.43)	0.85 (0.44–1.66)	0.65 (0.33–1.29)
Paternal orphan	1.39 (0.85–2.27)	0.86 (0.54–1.38)	1.07 (0.63–1.83)	0.98 (0.57–1.68)
Double orphan	0.96 (0.55–1.66)	1.04 (0.62–1.75)	0.93 (0.50–1.74)	0.70 (0.37–1.32)
Relationship to caregiver
Grandparent/aunt/uncle	1.13 (0.69–1.87)	1.05 (0.64–1.72)	1.03 (0.60–1.76)	1.70 (0.98 –2.95)
Sibling	0.94 (0.51–1.76)	0.78 (0.43–1.42)	0.90 (0.44–1.82)	1.83 (0.91–3.71)
Other	0.94 (0.43–2.09)	0.60 (0.28–1.30)	1.10 (0.49–2.45)	1.01 (0.45–2.28)
Female caregiver	0.61 (0.35–1.06)	1.58 (0.86–2.93)	0.58* (0.35–0.97)	1.00 (0.59–1.72)
Age of caregiver	1.00 (0.99–1.01)	0.99* (0.98–1.00)	1.00 (0.98–1.01)	0.98** (0.98–1.00)
Married caregiver	1.05 (0.76–1.46)	0.76 (0.56–1.04)	1.12 (0.79–1.55)	1.21 (0.87–1.68)
Caregiver has some education	1.32 (0.93–1.85)	0.87 (0.64 –1.19)	0.76 (0.53–1.08)	0.73 (0.51–1.03)
Ill household member	1.21 (0.91–1.61)	1.31* (1.00–1.72)	1.77*** (1.31–2.41)	1.44* (1.07–1.93)
Dependency ratio	1.05 (0.90–1.23)	0.86 (0.73–1.02)	1.01 (0.89–1.15)	0.90 (0.78–1.03)
Poverty
1000–2500 rand/month	0.88 (0.60–1.28)	1.35 (0.95–1.90)	0.76 (0.49–1.17)	1.14 (0.77–1.70)
>2500 rand/month	0.83 (0.41–1.69)	1.14 (0.60–2.20)	0.54 (0.23–1.28)	0.94 (0.47–1.89)
Peri-urban	2.14*** (1.46–3.15)	1.48 (0.99–2.22)	2.27*** (1.51–3.41)	1.42 (0.91–2.24)

OR, odds ratio; CI, confidence interval.

* p ≤ 0.05; **p ≤ 0.01; ***p ≤ 0.001.

Table 4. Multivariate models of high levels of psychological problems among caregivers.

	Negative feelings	Poor family functioning
	OR (CI)	OR (CI)
Paraprofessional model	0.67* (0.49–0.93)	0.42*** (0.29–0.59)
Round	0.71* (0.54–0.94)	3.80*** (2.82–5.13)
Paraprofessional*Round	1.60* (1.05–2.46)	1.44 (0.93–2.24)
Female	0.90 (0.55–1.46)	1.32 (0.80–2.15)
Age	1.00 (1.00–1.01)	0.99*** (0.98–0.99)
Married	0.66** (0.51–0.85)	0.98 (0.76–1.26)
Some education	0.77* (0.60–1.00)	0.95 (0.73–1.24)
Ill household member	2.47*** (1.96–3.10)	1.81*** (1.44–2.29)
Dependency ratio	1.04 (0.94–1.15)	1.01 (0.90–1.12)
Poverty
1000–2500 rand/month	0.82 (0.61–1.12)	1.05 (0.78–1.43)
>2500 rand/month	0.09*** (0.03–0.26)	0.46** (0.26–0.81)
Peri-urban	0.89 (0.63–1.25)	1.54* (1.10–2.17)

OR: odds ratio; CI: confidence interval.

* p ≤ 0.05; **p ≤ 0.01; ***p ≤ 0.001.