Title: From novice to expert: agroecological competences of children orphaned by AIDS compared to non-orphans in Benin
Author: Rose C Fagbemissi, Lisa L Price
Date: 2011
Abstract: Background: AIDS has created new vulnerabilities for rural African households due to prime-age adult mortality and is assumed to lead to impairment of the intergenerational transfer of farming knowledge. There has been scant research to date, however, on the impacts of parental death on farming knowledge of children made orphans by AIDS. The question we investigate is if there is a difference in agricultural expertise between AIDS affected and non-affected adults and children. Methods: The research was carried out in rural Benin with 77 informants randomly selected according to their AIDS status: 13 affected and 13 non-affected adults; 13 paternal, 13 maternal and 13 double orphans; and 12 non-orphan children. Informants descriptions from pile sorting exercises of maize and cowpea pests were categorized and then aggregated into descriptions based form (morphology) and function (utility) and used to determine whether the moving from novice to expert is impaired by children orphaned by AIDS. Differences and similarities in responses were determined using the Fischer exact test and the Cochran-Mantzel-Haenszel test. Results: No significant differences were found between AIDS affected and non-affected adults. Results of the study do reveal differences in the use of form and function descriptors among the children. There is a statistically significant difference in the use of form descriptors between one-parent orphans and non-orphans and in descriptors of specific damages to maize. One-parent paternal orphans were exactly like non-affected adults in their 50/50 balanced expertise in the use of both form and function descriptors. One-parent orphans also had the highest number of descriptors used by children overall and these descriptors are spread across the various aspects of the knowledge domain relative to non-orphans. Conclusions: Rather than a knowledge loss for one-parent orphans, particularly paternal orphans, we believe we are witnessing acceleration into adult knowledge frames. This expertise of one-parent orphans may be a result of a combination of factors deserving further investigation including enhanced hands-on work experience with the food crops in the field and the expertise available from the surviving parent coupled with the value of the food resource to the household.
[button link=” http://www.mendeley.com/research/novice-expert-agroecological-competences-children-orphaned-aids-compared-nonorphans-benin/” color=”green” newwindow=”yes”] View Online [/button]
Title: The motor development of children with and without HIV: pilot exploration of foster care and residential placement
Authors: Jennifer Jelsma, Naliah Davids, Gillian Ferguson
Date: 2011
Abstract: Background: The AIDS epidemic has lead to an increase in orphaned children who need residential care. It is known that HIV leads to delayed motor development. However, the impact of place of residence on motor function has not been investigated in the South African context. The aim of the study was therefore to establish if children in institutionalised settings performed better or worse in terms of gross motor function than their counterparts in foster care. A secondary objective was to compare the performance of children with HIV in these two settings with those of children who were HIV negative. Methods: Forty-four children both with and without HIV, were recruited from institutions and foster care families in Cape Town. The Peabody Development Motor Scale (PDMS II) was used to calculate the total motor quotient (TMQ) at baseline and six months later. Comparisons of TMQ were made between residential settings and between children with and without HIV. Results: Twenty-one children were infected with HIV and were significantly delayed compared to their healthy counterparts. Antiretroviral therapy was well managed among the group but did not appear to result in restoration of TMQ to normal over the study period. HIV status and place of residence emerged as a predictor of TMQ with children in residential care performing better than their counterparts in foster care. All children showed improvement over the six months of study. Conclusions: Foster parents were well supported administratively in the community by social welfare services but their children might have lacked stimulation in comparison to those in institutional settings. This could have been due to a lack of resources and knowledge regarding child development. The assumption that foster homes provide a better alternative to institutions may not be correct in a resource poor community and needs to be examined further.
[button link=” http://www.mendeley.com/research/motor-development-orphaned-children-without-hiv-pilot-exploration-foster-care-residential-placement/” color=”green” newwindow=”yes”] View Online [/button]
Title: Health of adults caring for orphaned children in an HIV-endemic community in South Africa
Authors: Caroline Kuo, Don Operario
Date: 2011
Abstract: Abstract In South Africa, an estimated 2.5 million children have been orphaned by AIDS and other causes of adult mortality. Although there is a growing body of research on the well-being of South African orphaned children, few research studies have examined the health of adult individuals caring for children in HIV-endemic communities. The cross-sectional survey assessed prevalence of general health and functioning (based on Short-Form 36 version 2 scale), depression (based on Center for Epidemiologic Studies-Depression scale), anxiety (using Kessler-10 scale), and post-traumatic stress (using the Harvard Trauma Questionnaire) among a representative community sample of adults caring for children in Umlazi Township, an HIV-endemic community in South Africa. Of 1599 respondents, 33% (n=530) were carers of orphaned children. Results showed that, overall, carers reported poor general health and functioning and elevated levels of depression, anxiety, and post-traumatic stress. Carers of orphaned children reported significantly poorer general health and functioning and higher rates of depression and post-traumatic stress compared with carers of non-orphaned children. In multivariate analyses, orphan carer and non-orphan carer differences in general health were accounted for by age, gender, education, economic assets, and source of income, but differences in depression were independent of these cofactors. Interventions are needed to address physical and mental health of carers in general. Greater health problems among orphan carers appeared to be fully explained by socioeconomic characteristics, which offer opportunities for targeting of programs. More research is needed to understand determinants of mental health disparities among orphan carers, which were not explained by socioeconomic characteristics.
[button link=” http://www.mendeley.com/research/health-adults-caring-orphaned-children-hivendemic-community-south-africa/” color=”green” newwindow=”yes”] View Online [/button]
Title: Depression among carers of AIDS-orphaned and other-orphaned children in Umlazi Township, South Africa
Authors: Kuo Caroline, Operario Don, Cluver Lucie
Date: 2012
Abstract: South Africa faces the challenge of supporting the well-being of adults caring for growing numbers of AIDS-orphaned children. These adults play a critical role in responses to the epidemic, but little information exists in regard to their mental health needs. This paper reports on findings from n=1599 adults, recruited through representative household sampling, who serve as primary carers for children in Umlazi Township, an HIV-endemic community. Overall, 22% of participants were carers of AIDS-orphaned children, 11% were carers of other-orphaned children and 67% were carers of non-orphaned children. Prevalence of depression was 30.3%. Orphan carers, regardless of whether they cared for AIDS-orphaned or other-orphaned children, were significantly more likely than carers of non-orphaned children to meet the clinical threshold for depression (35.2% vs. 27.9%, p < 0.01). In multivariate logistic regressions, food insecurity and being a female carer were identified as additional risk factors for greater depression. In contrast, households with access to running water and households dependent on salaries as the main source of income were identified as protective factors for disparities in depression. Mental health interventions are urgently needed to address an increased risk for depression among all orphan carers, not just those caring for AIDS-orphaned children. 2012 Copyright Taylor and Francis Group, LLC.
[button link=” http://www.mendeley.com/research/depression-among-carers-aids-orphaned-other-orphaned-children-umlazi-township-south-africa/” color=”green” newwindow=”yes”] View Online [/button]
Title: PEPFAR’s support for orphans and vulnerable children: some beneficial effects, but too little data, and progress spread too thin
Authors: Malcolm Bryant, Jennifer Beard, Lora Sabin, Mohamad I. Brooks, Nancy Scott, Bruce A. Larson,
Godfrey Biemba, Candace Miller, and Jonathon Simon
Date: July 2012
Abstract: Sixteen million children in developing and middle-income countries have been orphaned by HIV/AIDS, and at least another million children per year are rendered vulnerable by parental HIV/AIDS-related illness. Since 2003 the US government has provided approximately $1.6 billion to give four million of these children care and support through the President’s Emergency Plan for AIDS Relief (PEPFAR). We conducted five studies to evaluate the effectiveness of PEPFAR’s interventions for such children in East Africa and southern Africa. We found evidence of beneficial changes in school enrollment rates and on the psychosocial well-being of children. However, we could not demonstrate empirically the impact of most of the PEPFAR initiatives that we examined, primarily because of a lack of baseline data and clear outcome and impact indicators. We also found that many programs were spread so thin across a vulnerable population that little in the way of services actually reached beneficiaries, which raises questions about whether PEPFAR funds are sufficient, or if the program is attempting to do much with too few resources. We offer several recommendations, including better measuring the effect of programs for orphans and vulnerable children by collecting baseline data and conducting well-designed, rigorous outcome and impact evaluations.
[button link=”http://content.healthaffairs.org/content/31/7/1508.full” color=”green” newwindow=”yes”] View Online [/button]
Title: Sexual risk behavior among South African adolescents: is orphan status a factor?
Authors: Tonya R Thurman, Lisanne Brown, Linda Richter, Pranitha Maharaj, Robert Magnani
Date: 2006
Abstract: There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1,694 Black South African youth aged 14-18, of whom 31% are classified as orphaned, this analysis explores the relationship between orphan status and sexual risk. The analysis found both male and female orphans significantly more likely to have engaged in sex as compared to non-orphans (49% vs. 39%). After adjusting for socio-demographic variables, orphans were nearly one and half times more likely than non-orphans to have had sex. Among sexually active youth, orphans reported younger age of sexual intercourse with 23% of orphans having had sex by age 13 or younger compared to 15% of non-orphans. Programmatic implications of these findings for the care and protection of orphans are discussed.
[button link=”http://www.mendeley.com/research/sexual-risk-behavior-among-south-african-adolescents-orphan-status-factor/” color=”green” newwindow=”yes”] View Online [/button]
Title: Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?
Author: Laura Robertson, Simon Gregson, Geoff P Garnett
Date: 2010
Abstract: Previous studies from sub-Saharan Africa have found that orphans experience increased sexual risk compared to non-orphans. We developed a theoretical framework for the investigation of determinants of HIV risk and used it to generate specific hypotheses regarding the effect of country-level HIV prevalence on the sexual risk experience of orphans. We expected that countries with high HIV prevalence would experience a higher prevalence of orphanhood. We further hypothesised that orphans in countries with high HIV prevalence would experience increased sexual risk, compared to non-orphans, due to pressure on the extended family network, which is primarily responsible for the care of orphans in sub-Saharan Africa, resulting in poorer standards of care and guidance. We used hierarchical logistic regression models to investigate this hypothesis using cross-sectional, Demographic and Health Survey data from 10 sub-Saharan African countries. We found that countries with high HIV prevalence did indeed have higher prevalence of orphanhood. We also found that, amongst female adolescents, maternal and double orphans were significantly more likely to have started sex than non-orphans in countries with high HIV prevalence but were not at increased risk in low HIV prevalence countries. This effect of country-level HIV prevalence on the sexual risk of orphans was not explained by household level factors such as wealth, overcrowding or age of the household head. The same pattern of risk was not observed for male adolescents male orphans were not more likely to have started sex than non-orphans. This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children.
[button link=”http://www.mendeley.com/research/sexual-risk-among-orphaned-adolescents-countrylevel-hiv-prevalence-important-factor/” color=”green” newwindow=”yes”] View Online [/button]
Title: A longitudinal study of adolescents with perinatally or transfusion acquired HIV infection: sexual knowledge, risk reduction self-efficacy and sexual behavior
Authors: Lori S Wiener, Haven B Battles, Lauren V Wood
Date: 2007
Abstract: As HIV-positive children are surviving to adolescence and beyond, understanding their HIV knowledge and sexual behavior is critical. Forty HIV+ adolescents/young adults were interviewed twice, approximately 21 months apart (mean age 16.6 and 18.3 years, respectively). Data on demographics, safer sex knowledge, sexual risk behaviors, risk reduction self-efficacy, and Tanner stage were collected. Twenty-eight percent of HIV+ youth at Time 1 and 41% at Time 2 reported being sexually active. HIV transmission/safer sex knowledge was low, increased with age, and both self-efficacy for and actual condom use was relatively high. Secondary prevention messages should be incorporated into routine medical settings.
[button link=”http://www.mendeley.com/research/longitudinal-study-adolescents-perinatally-transfusion-acquired-hiv-infection-sexual-knowledge-risk-reduction-selfefficacy-sexual-behavior/” color=”green” newwindow=”yes”] View Online [/button]
Title: Gender differentials in the impact of parental death: Adolescent’s sexual behaviour and risk of HIV infection in rural South Africa.
Authors: Makandwe Nyirenda, Nuala McGrath, Marie-Louise Newell
Date: October 2010
Abstract: Using data from a longitudinal surveillance study from rural South Africa, we investigated the odds of sexual debut, pregnancy and HIV infection of 15- to 19-year-old adolescents by parental survival. Using descriptive statistics and logistic regressions, we examine the relative risk of orphans compared with non-orphans to have ever had sex, being pregnant and being HIV infected, adjusting for age, sex, socio-economic status, education, being employed and residency. Of 8274 adolescents, 42% were orphaned (one or both parents died). Over 80% of adolescents remained in school, but orphans were significantly more likely to lag behind in grade for age. Female adolescent maternal (aOR 1.32, 95% CI 1.07-1.62), paternal (aOR 1.26, 95% CI 1.06-1.49) and dual (aOR 1.37, 95% CI 1.05-1.78) orphans were significantly more likely than non-orphaned females to have ever had sex; among males it was only paternal (aOR 1.27, 95% CI 1.05-1.53) orphans. Maternal (aOR 1.49, 95% CI 1.03-2.15) and dual (aOR 1.74, 95% CI 1.11-2.73) female orphans relative to non-orphaned females were significantly more likely to be HIV infected; male paternal (aOR 3.41, 95% CI 1.37-8.46) and dual (aOR 3.54, 95% CI 1.06-11.86) orphans had over three-fold the odds of being infected. There was strong evidence that death of mother for girls was associated with increased vulnerability to earlier sexual debut and HIV infection, while fathers appeared to play a significant role in both their son’s and daughter’s lives.
[button link=”http://www.mendeley.com/research/gender-differentials-impact-parental-death-adolescents-sexual-behaviour-risk-hiv-infection-rural-south-africa/” color=”green” newwindow=”yes”] View Online [/button]
Title: Knowing kids dying of HIV: a traumatic event for AIDS orphans
Authors: Qun Zhao, Xiaoming Li, Xiuyun Lin, Xiaoyi Fang, Guoxiang Zhao, Junfeng Zhao
Date: 2009
Abstract: Data from 755 AIDS orphans living in a rural area of China with high rates of HIV infection were used to examine the association between a child’s trauma symptoms and knowing a peer with HIV infection or one who had died of HIV. Trauma symptoms were measured by the Traumatic Symptoms Checklist for Children-Chinese Version (TSCC-CV). About 47% of participants reported they knew a child with HIV or one who had died of HIV. More orphans living in family-based care reported such knowledge, and trauma symptoms were significantly higher in children who reported such knowledge. Multivariate analysis showed that such knowledge was significantly associated with traumatic symptoms, controlling for gender, age, family socioeconomic status, orphan status (double vs. single), and care arrangement (family-based vs. institutional care). The results underscored the importance of psychosocial support and counseling to orphans in communities with high levels of HIV-related mortality.
[button link=”http://www.mendeley.com/research/knowing-kids-dying-of-hiv-a-traumatic-event-for-aids-orphans/” color=”green” newwindow=”yes”] View Online [/button]