HIV-Associated Orphanhood and Children’s Psychosocial Distress: Theoretical Framework Tested With Data From Zimbabwe

Abstract

Nyamukapa et al. | Peer Reviewed | Research and Practice | 133 RESEARCH AND PRACTICE  Objectives. We measured the psychosocial effect of orphanhood in a subSaharan African population and evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children.Methods. The framework was evaluated using data from 5321 children aged 12 to 17 years who were interviewed in a 2004 national survey in Zimbabwe. We constructed a measure of psychosocial distress using principle components analysis. We used regression analyses to obtain standardized parameter estimates of psychosocial distress and odds ratios of early sexual activity.Results. Orphans had more psychosocial distress than did nonorphans. For both genders, paternal, maternal, and double orphans exhibited more-severe distress than did nonorphaned, nonvulnerable children. Orphanhood remained associated with psychosocial distress after we controlled for differences in more-proximate determinants. Maternal and paternal orphans were significantly more likely than were nonorphaned, nonvulnerable children to have engaged in sexual activity. These differences were reduced after we controlled for psychosocial distress.Conclusions. Orphaned adolescents in Zimbabwe suffer greater psychosocial distress than do nonorphaned, nonvulnerable children, which may lead to increased likelihood of early onset of sexual intercourse and HIV infection. The effect of strategies to provide psychosocial support should be evaluated scientifically.

Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?

“…HIV testing of older children has not been emphasized because, until recently, long-term survival in the absence of treatment following MTCT was thought to be uncommon. 20 This means that HIV testing for young people in Zimbabwe can only be accessed in health-care facilities, with no freestanding HIV-testing services for children less [21][22][23] We found that most children were diagnosed following presentation with acute illness; only a minority accessed testing through primary care or freestanding HIV-testing services.…”

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

“…Exposure to eight or more adversities increases the risk of negative mental outcomes by 5.7 times (Winslow et al,2005;Nyamukapa et al, 2008;Kumakech et al, 2009). Thus, the results of the empirical investigation indicated that all the children in the research group are at risk for poor developmental outcomes which may compromise their development and future success.…”

“…It usually involves a lengthy process of multiple stressors or adversities and changes occurring before, during and after the death. This process may include facing adversities such as parents' illness and death, consequent disintegration of the family structure, poverty, homelessness, relocation, trauma and major adjustments in placement in residential care, stigmatisation, societal discrimination, exploitation and abuse (Richter, 2004, Nyamukapa et al,2008.…”

Context Matters: Fostering, Orphanhood and Schooling in Sub-Saharan Africa

“…There is also a growing body of literature documenting the increased psycho-social vulnerability of such children (Bauman and Germann, 2005;Nyamukupa et al, 2008), although Levine et al (2005) have noted that, in many cases, the apparent 'exploitation' of fostered orphans (being taken out of school to perform farmwork, for example) may be essential for household survival.…”