Parental illness, caregiving factors and psychological distress among children orphaned by acquired immune deficiency syndrome (AIDS) in South Africa

Abstract

Studies show elevated levels of psychological distress among acquired immune deficiency syndrome (AIDS)-orphaned children. Caregiving factors are critical in child mental health, but little is known about their effects among AIDS-orphaned children. This study aimed to explore whether caregiving factors (e.g. caregiver illness, monitoring and abuse) mediated between orphanhood status and psychological problems. A total of 1025 children and adolescents (aged 10–19 years), living in South African urban informal settlements, were interviewed using sociodemographic questionnaires and standardized psychological scales of depression, anxiety, post-traumatic stress disorder, peer problems, delinquency and conduct problems. AIDS-orphaned children (n = 425) were compared to control groups of other-orphans (n = 241) and non-orphans (n = 278). Results showed that child abuse, domestic violence, sibling dispersion and changes of caregiver were associated with psychological problems for all children, but did not mediate between orphanhood and psychological distress. AIDS-orphaned children reported more caregiver illness and excessive housework, and these two factors mediated the strong associations between psychological distress and AIDS-orphanhood. These findings suggest that interventions addressing caregiver ill-health and supporting young carers may have potential to ameliorate psychological distress among AIDS-orphaned children.

Keywords:

• HIV/AIDS
• orphans
• care
• psychological health