Abstract: This paper modeled the proximate determinants of the scores on 60 items from Minnesota Multiphasic Personality Inventory-2 (MMPI) and of school participation of approximately 1,000 children who had lost their mothers due to AIDS and from other causes using the data from a survey in Ethiopia. The scores on MMPI items reflecting emotional and social adjustment, and school participation before and after maternal deaths were modeled in a multi-disciplinary framework incorporating the time sequence of events. The main findings were that while AIDS orphans scored lower on MMPI items, variables such as presence of the father, household income, feeding and clothing conditions, and attitude of the fostering family were significant predictors of children’s scores. Secondly, girls were at a disadvantage in terms of the scores on MMPI items. Third, variables such as income and good feeding and clothing conditions were significant predictors of school participation. Fourth, school participation before maternal death was an important predictor of subsequent school participation probabilities. An ordinal regression model was estimated to address certain methodological problems. Overall, the results indicated that economic subsidies to fostering households would enhance child welfare in Ethiopia.

Citation: Bhargava, A. (2005). “AIDS epidemic and the psychological well-being and school participation of Ethiopian orphans.” Psychology, Health & Medicine 10(3): 263-275.

The objective of this study was to use multiple measures and sources to assess mental health over time in uninfected 8- to 12-year-old children of HIV-positive mothers. METHODS. We recruited from the New York City Division of AIDS Services and Income Support a consecutive sample of 157 single mothers who were living with an HIV-negative child aged 8 to 12. Families were randomly assigned to receive a custody planning intervention, Project Care, or standard care. Data were collected at baseline and 4 subsequent times 6 months apart. Children completed the Children’s Depression Inventory; 8- to 10-year-olds completed the Terry, and 11- to 12-year-olds completed the Youth Self-Report. Mothers completed the Child Behavior Checklist. Each measure has a validated cutoff score to signify clinically significant symptoms. RESULTS. All 5 data points were available on 129 (82%) children. During 2 years, every child had a score in the clinical range (12% once, 25% twice, 26% 3 times, 27% 4 times, and 9% all 5 times). Clinically significant symptoms were most likely at baseline when mothers were sickest. Few had clinically significant symptoms based on maternal report only (5%) or child report only (8%). Chronicity of clinically significant symptoms was not related to child age or gender, maternal health or depression, parent-child relationship, or being assigned to Project Care. Although two thirds of the children received mental health services during the study, <25% did at any 1 time, and 28% of children with chronic clinically significant symptoms never received care. CONCLUSIONS. Children who are affected by AIDS should be routinely screened for psychiatric problems by using multiple measures and sources to avoid underidentification and be carefully monitored long-term.

Citation: Bauman, L. J., E. J. Silver, et al. (2007). “Children of Mothers With HIV/AIDS: Unmet Needs for Mental Health Services.” Pediatrics 120(5): e1141-1147.

More than 11 million children under 15 years in sub-Saharan Africa have lost at least one parent to AIDS. In Uganda, about 2 million children are orphans, with one or both parents dead. The objective of this study was to investigate the psychosocial consequences of AIDS orphanhood in a rural district in Uganda and to identify potential areas for future interventions. The study was conducted in a randomly selected sub-county in Bushenyi District in Uganda. The study population consisted of 123 children aged 11-15 years whose parents (one or both) were reported to have died from AIDS and 110 children of similar age and gender living in intact households in the same neighbourhood. Symptoms of psychological distress were assessed using the Beck Youth Inventories of Emotional and Social Impairment (BYI). The standardized interview also included questions concerning current and past living conditions. A multivariate analysis of factors with possible relevance for BYI outcome showed that orphan status was the only significant outcome predictor. Orphans had greater risk (vs. non-orphans) for higher levels of anxiety (odds ratios (OR) = 6.4), depression (OR = 6.6), and anger (OR = 5.1). Furthermore, orphans had significantly higher scores than non-orphans on individual items in the Beck Youth Depression Inventory that are regarded as particularly “sensitive” to the possible presence of a depressive disorder, i.e. vegetative symptoms, feelings of hopelessness, and suicidal ideation. High levels of psychological distress found in AIDS orphans suggest that material support alone is not sufficient for these children. (c) 2005 Elsevier Ltd. All rights reserved.

Citation: Atwine, B., E. Cantor-Graae, et al. (2005). “Psychological distress among AIDS orphans in rural Uganda.” Social Science & Medicine 61(3): 555-564.