The Role of Parenting in Affecting the Behavior and Adaptive Functioning of Young Children of HIV-Infected Mothers in South Africa

Allen, A. B.; Finestone, Michelle; Eloff, Irma; Sipsma, Heather; Makin, J.D.; Triplett, Kelli N.; Ebersöhn, Liesel; Sikkema, Kathleen J.; Briggs‐Gowan, Margaret J.; Visser, Maretha; Ferreira, Ronél; Forsyth, Brian W.C.

doi:10.1007/s10461-013-0544-7

Cited by 37 publications

(52 citation statements)

References 42 publications

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“…S1. Avoidant coping is common in HIV-infected mothers and can impact on parenting behaviours (Allen et al., 2014). The intervention aimed to shift the mother to a more active coping style, changing parenting behaviour towards disclosure, health education, and care and custody planning for the child.…”

Section: Methodsmentioning

confidence: 99%

Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa

Rochat

Mitchell

Lubbe

et al. 2017

Social Science & Medicine

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IntroductionChildren's understanding of HIV and death in epidemic regions is under-researched. We investigated children's death-related questions post maternal HIV-disclosure. Secondary aims examined characteristics associated with death-related questions and consequences for children's mental health.MethodsHIV-infected mothers (N = 281) were supported to disclose their HIV status to their children (6–10 years) in an uncontrolled pre-post intervention evaluation. Children's questions post-disclosure were collected by maternal report, 1–2 weeks post-disclosure. 61/281 children asked 88 death-related questions, which were analysed qualitatively. Logistic regression analyses examined characteristics associated with death-related questions. Using the parent-report Child Behaviour Checklist (CBCL), linear regression analysis examined differences in total CBCL problems by group, controlling for baseline.ResultsChildren's questions were grouped into three themes: ‘threats’; ‘implications’ and ‘clarifications’. Children were most concerned about the threat of death, mother's survival, and prior family deaths. In multivariate analysis variables significantly associated with asking death-related questions included an absence of regular remittance to the mother (AOR 0.25 [CI 0.10, 0.59] p = 0.002), mother reporting the child's initial reaction to disclosure being “frightened” (AOR 6.57 [CI 2.75, 15.70] p=<0.001) and level of disclosure (full/partial) to the child (AOR 2.55 [CI 1.28, 5.06] p = 0.008). Controlling for significant variables and baseline, all children showed improvements on the CBCL post-intervention; with no significant differences on total problems scores post-intervention (β -0.096 SE1.366 t = -0.07 p = 0.944).DiscussionThe content of questions children asked following disclosure indicate some understanding of HIV and, for almost a third of children, its potential consequence for parental death. Level of maternal disclosure and stability of financial support to the family may facilitate or inhibit discussions about death post-disclosure. Communication about death did not have immediate negative consequences on child behaviour according to maternal report.ConclusionIn sub-Saharan Africa, given exposure to death at young ages, meeting children's informational needs could increase their resilience.

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Section: Methodsmentioning

confidence: 99%

Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa

Rochat

Mitchell

Lubbe

et al. 2017

Social Science & Medicine

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“…In turn, caregiver psychological distress such as PTSD, depression and anxiety has been shown to affect parenting style and child behavior [12]. However, there is little research on pathways between these, particularly involving adolescents.…”

Section: Introductionmentioning

confidence: 99%

Pathways From Family Disadvantage via Abusive Parenting and Caregiver Mental Health to Adolescent Health Risks in South Africa

Meinck

Cluver

Orkin

et al. 2017

Journal of Adolescent Health

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Purpose Adolescent health is a major concern in LMIC but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral and physical health outcomes. This study, based in South Africa, aimed to develop an empirically-based theoretical model of relationships between family factors such as deprivation, illness and parenting and adolescent health outcomes. Methods Cross-sectional data were collected in 2009–2010 from 2477 adolescents (aged 10–17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on socio-demographics, psychological symptoms, parenting and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models and a structural equation model developed. Results The final model demonstrated that family disadvantage (caregiver AIDS -illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found. Conclusions Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families.

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“…Items were translated into four local languages, back-translated and piloted with 20 mothers (Eloff et al, 2014;Sipsma et al, 2013). Although the CBCL has been used in several South African studies (Boeving-Allen et al, 2014;Cluver, Gardner, & Operario, 2007;Eloff et al, 2014), it has not been standardised for South African samples.…”

Section: Data Collection Instrumentsmentioning

confidence: 99%

A comparative study of the psychological problems of HIV-infected and HIV-uninfected children in a South African sample

2018

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According to research children living with HIV experience elevated levels of depression, anxiety, ADHD and disruptive behavioural disorders. Although South Africa's paediatric population that is infected with the human immunodeficiency virus (HIV) is the largest worldwide, little research has been conducted on their mental health challenges. However, attributing high levels of mental health problems solely to their HIV status can be problematic as there may be other contributory factors. This research explored the mental health problems of HIV-infected children and compared these to the mental health problems of their HIV-unaffected peers from similar backgrounds. Data was gathered from two samples of child and caregiver pairs. HIV-infected children (aged 6-12 years) and their caregivers/mothers (n = 54) were recruited from the Kalafong paediatric clinic where they received medical treatment and routine ART. A comparison group of 113 HIV-uninfected children and their uninfected mothers were recruited from primary care clinics in the same community. Caregivers completed the Child Behaviour Checklist (CBCL) to assess children's mental health. Children completed the Self-Description Questionnaire (SDQ-I) and the Revised Children's Manifest Anxiety Scale (RCMAS). The scores of the psychometric sub-scales of the two groups were compared using parametric and non-parametric statistics. HIV-infected children experienced more somatic and affective problems, physiological anxiety, less ADHD and lower self-esteem than HIV-uninfected children in the comparison group, while controlling for age differences. The high levels of mental health problems of both groups of children may be attributed to similar difficult socio-economic circumstances. The fact that most infected children were not aware of their HIV-status could have influenced the results. Mental health services should not be limited to HIV-infected children but should form part of all health care services.

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The Role of Parenting in Affecting the Behavior and Adaptive Functioning of Young Children of HIV-Infected Mothers in South Africa

Cited by 37 publications

References 42 publications

Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa

Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa

Pathways From Family Disadvantage via Abusive Parenting and Caregiver Mental Health to Adolescent Health Risks in South Africa

A comparative study of the psychological problems of HIV-infected and HIV-uninfected children in a South African sample

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