title: Kinship care at community is better model to ensure psychosocial and economic security to orphans living with HIV than from care homes.
abstract: BACKGROUND
  There were about 24,000 children affected by AIDS living in Nepal in 2010; of these 5,000 AIDS orphans were in need of immediate support. The objective of this study was to investigate which model of care and support is more appropriate for improving psychosocial and economic security of AIDS orphans.
  
  
  METHODS
  With the documented 5200 cases of AIDS orphans from 42 districts at National Association of People Living with HIV, we purposively selected five districts - one from each development region, based on the highest number of AIDS orphans reported. From five districts, 56 HIV positive double orphans aged 8-18 years and their 42 caregivers were interviewed to find their psychosocial and economic situation.
  
  
  RESULTS
  Thirty nine (70%) orphans were found living in kinship care, while 17(30%) were living in institutional care homes. Orphans living in kinship were more optimistic, as they were backed by their close relatives 35 (90%), had birth certificates 35 (90%), ensured inherent family property 21 (54%), obtained basic needs like food, education and shelter from grandparents 23 (59%), and had more than five friends who visited their homes 26 (67%). While, the orphans living in institutional care homes 17(30%) had no birth certificates, fewer contacts with siblings 2 (12%), and none had friends outside the care homes.
  
  
  CONCLUSIONS
  Kinship care is better model for psychosocial and economic security for AIDS orphans in Nepal, rather than institutional care. Families can provide good protection to AIDS orphans if government provides minimum support to them.
authors.affiliation: Ministry of Health and population, National Center For AIDS and STD Control, Nepal. shivaachrya@yahoo.com
authors.forename: S L
authors.initials: SL
authors.lastname: Acharya
authors.forename: B R
authors.initials: BR
authors.lastname: Pokhrel
authors.forename: R
authors.initials: R
authors.lastname: Ayer
authors.forename: P
authors.initials: P
authors.lastname: Belbase
authors.forename: M
authors.initials: M
authors.lastname: Ghimire
authors.forename: O
authors.initials: O
authors.lastname: Gurung
mesh_terms: D000293:Adolescent; D002648:Child; D054540:Child, Orphaned / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005581:Foster Home Care; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D008297:Male; D009390:Nepal / Q000453:epidemiology; D019372:Orphanages / Q000706:statistics & numerical data; D011584:Psychology; D012959:Socioeconomic Factors