The dyadic effects of HIV stigma on the mental health of children and their parents in South Africa

Gamarel, Kristi E.; Kuo, Caroline; Boyes, Mark; Cluver, Lucie

doi:10.1080/15381501.2017.1320619

Cited by 27 publications

(18 citation statements)

References 42 publications

(56 reference statements)

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“…Cultural and linguistic estrangement may retain migrants in deprived socioeconomic environments and limit their interaction with wealthier segments of society, but nothing isolates like the social stigma of HIV, even among peers. Recent studies from South Africa demonstrate how HIV continues to be severely stigmatised within families and local communities (Gamarel et al 2017;Steenberg 2019a). In one telling illustration of this, businesses with known HIV-positive workers were shown to lose up to half of their customers out of fear of transmission and disdain for people living with HIV (Chao et al 2017).…”

Section: Sociocultural Estrangement and Stigmamentioning

confidence: 99%

Structural vulnerabilities and healthcare services integration

Steenberg¹

2020

MAT

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Home to one fifth of all people living with HIV, South Africa carries the world’s heaviest burden of this disease. While a significant proportion of those infected are immigrants from other African high-prevalence countries, little is known about how these migrants engage with healthcare systems in shifting cultural and clinical settings. This article draws on fieldwork from migrant communities and twenty-one ethnographic life histories told by HIV-positive Mozambicans in a major South African HIV clinic. From their collective narratives, a range of structural vulnerabilities are found that limit immigrants’ access to,and proper integration within,healthcare services. These include perilous migration, xenophobia and deportation, exclusion and exploitation, language barriers, medical pluralism, cultural estrangement, social isolation, and the stigmas of being HIV-positive. In conjunction, these structural factors may delay treatment-seeking and inhibit drug adherence, which could increase rates of morbidity and mortality as well as contribute to viral mutation and antiretroviral drug resistance.

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Section: Sociocultural Estrangement and Stigmamentioning

confidence: 99%

Structural vulnerabilities and healthcare services integration

Steenberg¹

2020

MAT

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“…South Africa has the highest population of individuals living with HIV/AIDS, with a large population of orphaned youth, estimated at 2.3 million youth (UNICEF 2015). The high prevalence of HIV/AIDS in South Africa is accompanied by high levels of HIV-related stigma manifesting in various ways from peer rejection and violence to murder (Gamarel et al 2017). Thirty percent of the Western Cape Province's population consisted of children, of whom 6.7% of children were orphaned either paternally, maternally, or both.…”

Section: Study Settingmentioning

confidence: 99%

“…Children in HIV/AIDS-affected families are likely to suffer from stigmatisation at home, at school, and within their leisure environments (Xu et al 2009). Therefore, the possibility exists that the cause of paternal bereavement leads to the stigmatisation of COA regardless of their own HIV status (Chi et al 2014;Gamarel et al 2017;Thurman et al 2006). Goffman's (1963) conceptualisation of tribal stigma represents the devaluation, rejection, and victimisation of COA based on their relationship with a stigmatised individual/s, being their HIV-positive parent/s.…”

Section: Introductionmentioning

confidence: 99%

Qualitative exploration of HIV-related stigma and the psychosocial well-being of children orphaned by AIDS

2019

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Children orphaned by AIDS continue to display lower levels of psychosocial well-being. While HIV-related stigma has been identified as a risk factor for healthy psychosocial development, there remains an inadequate understanding of orphaned children's experiences and perceptions of HIV-related stigma and its impact on their psychosocial well-being. This study explored children orphaned by AIDS perceptions and experiences of HIV-related stigma and how it has affected their psychosocial wellbeing. This study used a qualitative exploratory descriptive design. Thirteen participants between 8 and 17 years of age were purposively selected. Data was collected using individual open-ended face-to-face interviews, observations and field notes. Data was transcribed and analysed using a thematic analysis. Three key themes emerged, (1) children's experiences of stigma and discrimination; (2) children's perceptions of HIV-related stigma; (3) and the psychosocial well-being of children orphaned by AIDS. Children were highly perceptive and experienced HIV-related stigma as a result of their association with parental HIV/ AIDS, regardless of their own HIV status. Experiences and perceptions of HIV-related stigma were identified to negatively impact the psychological and emotional well-being, social well-being, perceived social support, self-concept and self-esteem, and future orientation of orphaned children. This qualitative study contributes towards an understanding of orphaned children's experiences and perceptions of HIV-related stigma and how it may affect their psychosocial well-being, which is useful for informing future research and policies and programmes guided towards ensuring the well-being of children orphaned or made vulnerable by AIDS.

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“…There is often a mental health burden for children affected by HIV ( Sherr et al, 2018 ; Skeen et al, 2016 , 2017 ) including mood disorders (depression, suicidal behaviours and anxiety), trauma (posttraumatic stress), psychosocial challenges (including stigma, social withdrawal, poor confidence, poor self-efficacy and poor self-esteem; Gentz et al, 2018 ; Mellins et al, 2018 ; Vreeman et al, 2017 ; Walsh et al, 2017 ). Many of the lived experiences in HIV-affected households in resource limited settings, such as the communities from which the data for this study was obtained, can contribute to child difficulties ( Collishaw et al, 2016 ; Gamarel et al, 2017 ; Woollett et al, 2017 ). For example, children exposed to household overcrowding, unemployment, orphanhood, abuse, community violence, and informal housing are known to be at greater risk for depression ( Anda et al, 2006 ; Barbarin et al, 2001 ; Cluver & Gardner, 2007 ; Cluver et al, 2015 ; Gilman et al, 2002 ).…”

Section: Introductionmentioning

confidence: 99%

Depressive symptoms among children attending community based support in South Africa – pathways for disrupting risk factors

Sherr

Yakubovich

Skeen

et al. 2020

Clin Child Psychol Psychiatry

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Children in Southern Africa are exposed to high rates of structural and family adversities. This study tests whether services from Community Based Organisations (CBOs) in South Africa can promote children’s resilience against depression exposed to such adversities. Two linked longitudinal studies were conducted, comprising n = 1848 children aged 9 to 13 years. One group received CBO services, whilst the other (quasi-control) did not. Analyses used interaction terms in regression models to test for potential moderation effects of CBO attendance, and marginal effects models to interpret significant interactions. Two interaction effects were shown, demonstrating moderation effects of CBO attendance on common structural disadvantages. First, children exposed to community violence showed increased depression (contrast = 0.62 [95%CI 0.43, 0.82], p < .001), but this association was removed by CBO access (contrast = 0.07 [95%CI −0.28, 0.43], p = .682). Second, children living in informal housing showed increased depression (contrast = 0.63 [95%CI 0.42, 0.85], p < .001), however, this association was removed by CBO access (contrast = 0.01 [95%CI −0.55, 0.56], p = .977). CBO attendance is associated with fewer depressive symptoms, and can buffer against important structural adversities of poor housing and violence that are common in high HIV-prevalence areas. However, CBO attendance was not able to remove the increased psychosocial distress associated with some family-level vulnerabilities such as orphanhood and abuse. These findings highlight the centrality of CBO-provided psychosocial support for children in Southern Africa, and suggest areas for bolstering provision.

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The dyadic effects of HIV stigma on the mental health of children and their parents in South Africa

Cited by 27 publications

References 42 publications

Structural vulnerabilities and healthcare services integration

Structural vulnerabilities and healthcare services integration

Qualitative exploration of HIV-related stigma and the psychosocial well-being of children orphaned by AIDS

Depressive symptoms among children attending community based support in South Africa – pathways for disrupting risk factors

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