AIDS-orphanhood and caregiver HIV/AIDS sickness status: effects on psychological symptoms in South African youth.
OBJECTIVE
Research has established that AIDS-orphaned youth are at high risk of internalizing psychological distress. However, little is known about youth living with caregivers who are unwell with AIDS or youth simultaneously affected by AIDS-orphanhood and caregiver AIDS sickness.


METHODS
1025 South African youth were interviewed in 2005 and followed up in 2009 (71% retention). Participants completed standardized measures of anxiety, depression, and posttraumatic stress. Comparison groups were youth who were AIDS-orphaned, other-orphaned, and nonorphaned, and those whose caregivers were sick with AIDS, sick with another disease, or healthy.


RESULTS
Longitudinal analyses showed that both AIDS-orphanhood and caregiver AIDS sickness predicted increased depression, anxiety, and posttraumatic stress symptoms over a 4-year period, independently of sociodemographic cofactors and of each other. Caregiver sickness or death by non-AIDS causes, and having a healthy or living caregiver, did not predict youth symptomatology. Youths simultaneously affected by caregiver AIDS sickness and AIDS-orphanhood showed cumulative negative effects.


CONCLUSIONS
Findings suggest that policy and interventions, currently focused on orphanhood, should include youth whose caregivers are unwell with AIDS.
Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Oxford University, 32 Wellington Square, Oxford, OX1 2ER, UK. lucie.cluver@spi.ox.ac.uk
Lucie D
LD
Cluver
Mark
M
Orkin
Mark E
ME
Boyes
Frances
F
Gardner
Joy
J
Nikelo
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D001007:Anxiety / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D054540:Child, Orphaned / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D013019:South Africa; D013315:Stress, Psychological / Q000523:psychology