Positive parenting for positive parents: HIV/AIDS, poverty, caregiver depression, child behavior, and parenting in South Africa

Abstract

Families affected by HIV/AIDS in the developing world experience higher risks of psychosocial problems than non-affected families. Positive parenting behavior may buffer against the negative impact of child AIDS-orphanhood and caregiver AIDS-sickness on child wellbeing. Although there is substantial literature regarding the predictors of parenting behavior in Western populations, there is insufficient evidence on HIV/AIDS as a risk factor for poor parenting in low- and middle-income countries. This paper examines the relationship between HIV/AIDS and positive parenting by comparing HIV/AIDS-affected and non-affected caregiver-child dyads (n = 2,477) from a cross-sectional survey in KwaZulu-Natal, South Africa (27.7% AIDS-ill caregivers; 7.4% child AIDS-orphanhood). Multiple mediation analyses tested an ecological model with poverty, caregiver depression, perceived social support, and child behavior problems as potential mediators of the association of HIV/AIDS with positive parenting. Results indicate that familial HIV/AIDS’s association to reduced positive parenting was consistent with mediation by poverty, caregiver depression and child behavior problems. Parenting interventions that situate positive parenting within a wider ecological framework by improving child behavior problems and caregiver depression may buffer against risks for poor child mental and physical health outcomes in families affected by HIV/AIDS and poverty.

‘At school I got myself a certificate’: HIV/AIDS Orphanhood and Secondary Education: a Qualitative Study of Risk and Protective Factors

“…Families with AIDS-ill caregivers or households with only one surviving parent often removed children from school if the main breadwinner was ill or deceased to earn money, which was consistent with Lachman et al (2013). 'I dropped out of school….…”

Caregiving and Experiences of Health, Illness and Coping in the Context of Paediatric and Adolescent HIV and Poverty

“…However, the study does suggest that a parenting programme that is aimed at improving caregiver psychological health and encouraging positive parenting has the potential to safeguard against risks of poor child psychological and physical health outcomes in HIV-afected families living in poverty. This inding is promising that HIV-exposed caregivers have the ability to engage positively with their children, albeit, as the inding suggests, the efect size was small [31]. This nevertheless suggests, if adequately tailored interventions are implemented to look at strengthening the child-caregiver relationship, that it can ameliorate the children's response to the exposed adversities.…”

“…The beneit of interventions focusing on caregiver-child dyads has the potential to have a longlasting resilient efect on both children and their HIV-positive caregivers. Recently, the irst large study that examined the relationship between HIV/AIDS and positive parenting, using a sample of 2477 caregiver-child dyads, was conducted in KwaZulu-Natal [31]. Findings from the study indicated that HIV-positive caregivers and those caring for AIDS-orphaned children engaged in less positive parenting in comparison to non-afected families.…”

“…Furthermore, economic deprivation creates a catalyst for psychological stress and vulnerability among caregivers, which further predisposes them to depression [28]. Hence, a caregiver confronting impoverishment on a daily basis is more likely to be stressed, which in turn may impede the quality and quantity of her parenting [9,31]. The implication of this dynamic has an overwhelmingly negative efect on the child's developmental outcome.…”

Family quality of life in families affected by HIV: the perspective of HIV-positive mothers

“…Studies have shown that families affected by a chronic disease have low family cohesion, report more isolation, and have more communication difficulties and more intrafamily conflicts compared to families where all members are healthy (Alderfer, Navsaria, & Kazak, 2009;Barakat, Lutz, Smith-Whitley, & Ohene-Frempong, 2005;Pai et al, 2007). Families affected by HIV distinguish themselves in terms of resiliency, social support, parentification (i.e., the adoption of parental roles by children), and the physical and emotional health of parents and children (Lachman, Cluvera, Boyesa, Kuob, & Casale, 2013;Lester et al, 2010;Li, Lin, Ji, Sun, & Rotheram-Borus, 2009;Murphy, Roberts, & Hoffman, 2002). Murphy, Herbeck, Marelich, and Schuster (2010) found that high levels of anxiety in mothers living with HIV (MLHIV) have a negative impact on their parenting skills.…”