title: Exploring the care relationship between grandparents/older carers and children infected with HIV in south-western Uganda: implications for care for both the children and their older carers.
abstract: The care of children orphaned by HIV/AIDS in sub-Saharan Africa is often undertaken by grandparents, yet little is known about the care relationship between grandparent and grandchild. Our aim was to examine this relationship to understand the needs and responsibilities of both the HIV positive child and older carer and the nature of the relationship, and to assess the implications for care for the children and the older carers. A qualitative study was conducted with 40 purposively sampled children (13-17 years) and their older carers (50 years and above). Participants were recruited from two clinics in south-western Uganda. Up to three semi-structured interviews were held with each participant. Data were analysed using a thematic framework approach. We found that the care relationship was mostly reciprocal: HIV positive children depended on carers for basic and health needs and carers counted on the children for performing tedious household tasks. The relationship was also characterised by challenges, sometimes causing tension between child and carer. We conclude that: (1) interventions targeting HIV positive children need to also address the needs of older carers, and (2) carers and children would benefit from psychosocial support and social protection.
authors.affiliation: Medical Research Council, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda. rwamahe.rutakumwa@mrcuganda.org.
authors.forename: Rwamahe
authors.initials: R
authors.lastname: Rutakumwa
authors.affiliation: Medical Research Council, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda. flavia.zalwango@mrcuganda.org.
authors.forename: Flavia
authors.initials: F
authors.lastname: Zalwango
authors.affiliation: Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. esther.richards@lstmed.ac.uk.
authors.forename: Esther
authors.initials: E
authors.lastname: Richards
authors.affiliation: Medical Research Council, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda. janet.seeley@lshtm.ac.uk.|Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. janet.seeley@lshtm.ac.uk.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D054540:Child, Orphaned; D005260:Female; D000066502:Grandparents; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014454:Uganda / Q000453:epidemiology