Child prosociality within HIV-affected contexts: the impact of carer ill-health and orphan status

ABSTRACT

Considerable attention has been provided to the potential adverse outcomes for youth in the context of HIV and AIDS. Using data from a large community-based study on the psychosocial well-being of youth affected by HIV and AIDS, this paper advances a strength-based, resiliency perspective that is centred on the construct of prosociality. Data was derived from the Young Carers South Africa Project, where a cross-sectional household survey was conducted with 2477 child–carer pairs in an HIV-endemic community in the province of KwaZulu-Natal, South Africa. Analysis in this paper focuses on a subset of 2136 child–carer pairs. Perceptions of child prosociality were assessed using the Prosocial Scale of the Strengths and Difficulties Questionnaire (SDQ). Both child and carer responses were obtained to provide insight into the functioning of carer–child dyads. Descriptive and inferential analysis was conducted to explore ratings of child prosociality across different relational contexts affected by HIV and involving care for orphaned youths. Dual-affected households, where carers are ill with opportunistic infections and youth are orphaned due to AIDS, yielded the highest discrepancies with carers reporting low child prosociality and children self-reporting high prosociality. Carer ill health appears to play a role in differentiating child prosociality across relational contexts involving non-orphaned youth. Further research is needed to explore child prosociality as a protective mechanism in high HIV-endemic communities.

KEYWORDS:

• Carer–child dyad
• HIV and AIDS
• orphan
• prosocial behaviour
• South Africa

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. A primary carer may be a biological or foster parent. He/she assumes the main responsibility for addressing the economic and psychosocial welfare of the child.

2. The term ‘clinical’ is used to denote low levels of prosociality that may be suggestive of heightened behavioural risk.

Additional information

Funding

The Young Carers study was funded by the Health Economics and HIV and AIDS Research Division (HEARD) at the University of KwaZulu-Natal (SA), the Economic and Social Research Council (UK), the National Research Foundation (SA), the National Department of Social Development (SA), the Claude Leon Foundation, and the John Fell Fund. Contributions from Lucie Cluver were supported by a European Research Council (ERC) grant under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ ERC grant agreement n°313421, the Philip Leverhulme Trust (PLP-2014-095) and the ESRC Impact Acceleration Account. Additional support was provided to C. Kuo for analysis and writing by the US National Institute of Mental Health grant awards K01 MH096646 and L30 MH098313 and National Institute of Child Health and Human Development grant award R24 HD077976. We acknowledge the contribution of the Young Carers KwaZulu-Natal research team and Tholulwazi Uzivikele, the local NGO partner in the rural site.