Orphanhood by AIDS-Related Causes and Child Mental Health: A Developmental Psychopathology Approach

Abstract

While the number of new HIV infections has declined, the number of orphans as a result of AIDS-related deaths continues to increase. The aim of this paper was to systematically review empirical research on the mental health of children affected by HIV/AIDS in the developing world, specifically with an eye on developing a theoretical framework to guide intervention and research. Articles for review were gathered by following the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA standards), reviewed and then organized and synthesized with a Developmental Psychopathology framework. Results showed that the immediate and longterm effects of AIDS orphanhood are moderated by a number of important risk and protective factors that may serve as strategic targets for intervention. Research and clinical implications are discussed.

HIV-1 subtypes and drug resistance mutations among female sex workers varied in different cities and regions of the Democratic Republic of Congo

“…Based on env sequencing, the predominant HIV-1 subtype found in FSW was A1, which is consistent with recent reports from the DRC general population [1,8,18]. We detected HIV-1 recombinants (35%), primarily in pol sequences, from DRC FSWs.…”

“…Out of the 145 amplifiable samples, we obtained 93 pol sequences for determination of recombination or subtype discordance between the paired env and pol genes. The remaining specimens did not PCR amplify pol due either to low HIV-1 copies, or inadequate primer annealing resulting from sequence variation in the primer binding sites [18]. The 93 individual pol and 145 env sequences analyzed segregated geographically as follows: 23 (pol) and 37 (env) from Mbuji-Mayi, 10 (pol) and 18 (env) from Lubumbashi,13 (pol) and 22 (env) sequences from Kinshasa, 25 (pol) and 32 (env) from Goma, , 4 (pol) and 8 (env) from Kananga, 2 (pol) and 5 (env) from Kindu, 4 (pol) and 5 (env) from Kisangani, 6 (pol) and 9 (env) from Bukavu, 3 (pol) and 5 (env) from Mbandaka, and 3 (pol) and 4 (env) from Matadi (S1 Table).…”

“…Importantly, ART scale-up coincided with increases in detection of DRMs in treatment naïve patients, from 7.9% in 2008 to 10% in 2013-2014. Such increases included a high proportion of DRMs that limit the effectiveness of the first-line ART regimen utilized in the DRC [15,18].…”

Enrolling HIV-positive adolescents in mental health research: A case study reflecting on legal and ethical complexities

“…[10] An orphanhood epidemic has matured alongside the HIV epidemic, with high rates of adolescent orphans. In 2012, the overall national level of orphans aged <18 years was 16.9% (maternal 4.4%, paternal 9.3%, double 3.2%).…”

“…[19] There is a higher prevalence of HIV infection among orphans due to AIDS causes than among non-orphans and orphans of non-AIDS causes, together with earlier sexual debut, an increased risk of intergenerational sex, and increased family violence and exploitation. [10,[34][35][36][37] OVCY are increasingly recognised as a special population for HIV risk and transmission. [35] OVCY, child-headed households and children and youth without an official guardian are a unique and contemporary issue placing many SA institutions (including government) under tremendous pressure.…”