Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya.
OBJECTIVE
To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya.


METHODS
Randomly selected adolescents aged 10-18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver-child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk.


RESULTS
Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver-youth communication were more strongly associated with lower sex-related self-efficacy for orphans.


CONCLUSIONS
Orphans are at higher risk for psychosocial problems. These problems may affect orphans' self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans.
International Rescue Committee, 122 East 42nd Street, 12th Floor, New York, NY 10168, USA. Eve.Puffer@duke.edu
Eve S
ES
Puffer
Anya S
AS
Drabkin
Allison L
AL
Stashko
Sherryl A
SA
Broverman
Rose A
RA
Ogwang-Odhiambo
Kathleen J
KJ
Sikkema
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D017028:Caregivers; D002648:Child; D054540:Child, Orphaned / Q000523:psychology*; D003142:Communication; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006679:HIV Seropositivity; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D008603:Mental Health; D063129:Parental Death; D012307:Risk Factors; D012309:Risk-Taking; D012423:Rural Health; D012424:Rural Population; D020377:Self Efficacy; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors