Psychological distress amongst AIDS‐orphaned children in urban South Africa

Cluver, Lucie; Gardner, Frances; Operario, Don

doi:10.1111/j.1469-7610.2007.01757.x

Cited by 337 publications

(353 citation statements)

References 48 publications

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“…The effects of HIV/AIDS devastate the lives of millions of children, and the anticipated extent of the mounting crisis is enormous (Cluver et al, 2007;Mangoma et al, 2008). The global number of children under the age of 15 years who have lost one or both parents to HIV/AIDS is expected to increase from approximately 14 million in 2004 to 25 million by 2010 (Gulaid, 2004;UNAIDS, UNICEF & USAID, 2004).…”

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility

Pienaar¹,

Swanepoel

Rensburg³

et al. 2011

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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This article presents the findings of a study among a small group of South African AIDS orphans living in a residential care facility, Lebone Land. The research was conducted between June and September 2006. A qualitative, exploratory study consisting of in-depth, semistructured interviews with eight children and seven key informants aimed to identify and investigate developmental assets operating in the children's lives to help them cope amid exposure to adversities. The findings indicate that the developmental assets that facilitate coping and foster resilience in these children relate to four main components: external stressors and challenges, external supports, inner strengths and interpersonal and problem-solving skills. Emerging key themes relate to the experience of illness, death, poverty and violence, as well as the important roles of morality, social values, resistance skills, religion and faith in assisting these children in defining their purpose in life. To this end, constructive use of time, commitment to learning, goal-setting, problem-solving ability and self-efficacy are fundamental in the children's attainment of their future projections. Therefore, qualities such as optimism, perseverance and hope seem to permeate the children's process of recovery. Strong networks of support, particularly friendships with other children, also seem to contribute to developing and sustaining resilience.Keywords: resilience, HIV/AIDS affected children, pre-adolescence, residential care. RésuméCet article présente les conclusions d'une étude réalisée au sein d'un petit groupe d' orphelins du Sida sud-africains vivant dans une institution, Lebone Land. L' étude a été conduite de juin à septembre 2006. Une étude qualitative préliminaire consistant en entretiens approfondis et semi-structurés avec huit enfants et sept informateurs clés a visé à identifier et à étudier les facteurs développementaux à l'action dans les vies des enfants afin de les aider à faire face aux difficultés auxquelles ils se trouvent confrontés. Les conclusions indiquent que les facteurs développementaux aidant à faire face aux difficultés et favorisant la résilience chez ces enfants sont associés à quatre composantes principales : les facteurs de stress et les défis externes, les soutiens externes, les forces intérieures et les compétences interpersonnelles et de résolution de problèmes. Les thèmes clés qui émergent se rapportent à l' expérience de la maladie, de la mort, de la pauvreté et de la violence, ainsi qu'aux rôles importants de la moralité, des valeurs sociales, des compétences de résistance, de la religion et de la foi pour aider ces enfants à trouver leur but dans la vie. A cette fin, une utilisation constructive du temps, un dévouement à l'apprentissage, la fixation d' objectifs, la capacité à résoudre des problèmes et l'auto-efficacité sont essentiels pour permettre à l' enfant de réaliser ses projets d'avenir. Par conséquent, des qualités telles que l' optimisme, la persévérance et l' espoir semblent imprégner le proces...

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Section: Introductionmentioning

confidence: 99%

A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility

Pienaar¹,

Swanepoel

Rensburg³

et al. 2011

SAHARA-J: Journal of Social Aspects of HIV/AIDS

View full text Add to dashboard Cite

show abstract

“…Other investigators also documented a decrease in caregiving for AIDS orphans and vulnerable children in both Kenya and Ghana [31]. Clearly, children affected by HIV/AIDS may lack social support compared to non-orphans [1]. Delva and colleagues also confirmed the sparse social network of friends and low social support from the family for AIDS orphans in Guinea [5].…”

Section: Introductionmentioning

confidence: 61%

“…These models established whether perceived social support among the orphanhood groups persists independently of socio-demographic cofactors. Inclusion of socio-demographic co-factors into the models was guided by their significant association (p<0.05) with the perceived social support or significant differences between the orphanhood groups [1]. Based on using General Linear Models involving 8 predictors and working at .05 level of significance, the GPower estimated that a minimum sample size of 59 children in each group of the 4 groups (237 in total) was sufficient to obtain power of 95% to detect a small effect (0.10 effect size).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…The lack of access to antiretroviral treatment and the protracted and latent nature of HIV/AIDS mean that increasing numbers of children will have to spend much of the childhood years with an infected parent or as an orphan [1,2]. Parental illness or loss of parents permeates all aspects of a child's life and often marks the beginning of a drastic change in their lives.…”

Section: Introductionmentioning

confidence: 99%

“…Parental deaths and illnesses are childhood traumatic events that are associated with several negative physical, psychiatric and psychosocial health problems [3]. Prior work have highlighted that children orphaned by AIDS are at risks for a range of adjustment difficulties including emotional problems [1,4], behavioural difficulties [5] self-esteem [6], suicide ideation [7], anxiety [8,9] conduct problems [1,10], post-traumatic stress disorder [1,4,11], delinquency problems [1,6,12,13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Social Support Disparities among Children affected by HIV/AIDS in Ghana

Doku

Dotse²,

Mensah³

2015

J Psychiatry

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Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Trauma-Affected Children in Lusaka, Zambia

et al. 2015

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IMPORTANCE Orphans and vulnerable children (OVC) are at high risk for experiencing trauma and related psychosocial problems. Despite this, no randomized clinical trials have studied evidence-based treatments for OVC in low-resource settings.OBJECTIVE To evaluate the effectiveness of lay counselor-provided trauma-focused cognitive behavioral therapy (TF-CBT) to address trauma and stress-related symptoms among OVC in Lusaka, Zambia. DESIGN, SETTING, AND PARTICIPANTSThis randomized clinical trial compared TF-CBT and treatment as usual (TAU) (varying by site) for children recruited from August 1, 2012, through July 31, 2013, and treated until December 31, 2013, for trauma-related symptoms from 5 community sites within Lusaka, Zambia. Children were aged 5 through 18 years and had experienced at least one traumatic event and reported significant trauma-related symptoms. Analysis was with intent to treat. INTERVENTIONSThe intervention group received 10 to 16 sessions of TF-CBT (n = 131). The TAU group (n = 126) received usual community services offered to OVC. MAIN OUTCOMES AND MEASURESThe primary outcome was mean item change in trauma and stress-related symptoms using a locally validated version of the UCLA Posttraumatic Stress Disorder Reaction Index (range, 0-4) and functional impairment using a locally developed measure (range, 0-4). Outcomes were measured at baseline and within 1 month after treatment completion or after a waiting period of approximately 4.5 months after baseline for TAU.RESULTS At follow-up, the mean item change in trauma symptom score was −1.54 (95% CI, −1.81 to −1.27), a reduction of 81.9%, for the TF-CBT group and −0.37 (95% CI, −0.57 to −0.17), a reduction of 21.1%, for the TAU group. The mean item change for functioning was −0.76 (95% CI, −0.98 to −0.54), a reduction of 89.4%, and −0.54 (95% CI, −0.80 to −0.29), a reduction of 68.3%, for the TF-CBT and TAU groups, respectively. The difference in change between groups was statistically significant for both outcomes (P < .001). The effect size (Cohen d) was 2.39 for trauma symptoms and 0.34 for functioning. Lay counselors participated in supervision and assessed whether the intervention was provided with fidelity in all 5 community settings. CONCLUSIONS AND RELEVANCEThe TF-CBT adapted for Zambia substantially decreased trauma and stress-related symptoms and produced a smaller improvement in functional impairment among OVC having experienced high levels of trauma.

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Psychological distress amongst AIDS‐orphaned children in urban South Africa

Abstract: Children orphaned by AIDS may be a particularly vulnerable group in terms of emotional and, to a lesser extent, behavioural problems. Intervention programs are necessary to ameliorate the psychological sequelae of losing a parent to AIDS.

Cited by 337 publications

References 48 publications

A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility

A qualitative exploration of resilience in pre-adolescent AIDS orphans living in a residential care facility

Social Support Disparities among Children affected by HIV/AIDS in Ghana

Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Trauma-Affected Children in Lusaka, Zambia

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