Burden Among Caregivers of Children Living with Human Immunodeficiency Virus in North India.
BACKGROUND
Due to wider access to and free antiretroviral therapy (ART) program, the number of children dying due to acquired immune deficiency syndrome (AIDS)-related causes has declined and the nature and duration of human immunodeficiency virus (HIV)/AIDS caregiving has also dramatically altered. The care of children living with HIV/AIDS (CLHA) places a significant additional burden on the caregivers.


OBJECTIVE
This study was conducted to assess the perceived burden among caregivers of children living with HIV in North India.


METHODS
A hospital-based cross-sectional study among 156 CLHA-caregiver dyads in North India was conducted from June 2010 to May 2011. Data were collected by using a pretested structured interview schedule. The caregiver burden was measured with a 36-item scale adapted from Burden Assessment Schedule of Schizophrenia Research Foundation (BASS). Child characteristics, caregiver characteristics, caregiving burden, the knowledge of caregivers, and issues related to health care, nutrition, education, and psychological aspects were studied.


RESULTS
Caregivers had a mean age of 35.9 ± 10.2 years. Women accounted for over three-fourth (76.9%) of the caregivers. Nearly two-third of them (65.4%) reported as living with HIV. The mean caregiver burden score was 68.7 ± 2.9. A majority of the caregivers reported either low or moderate burden. Standardized percentage score was high in the domains of physical and mental health, external support, patients' behavior, and caregivers' strategy and seemed to be comparatively less in the other domains such as support of the patient and taking responsibility.


CONCLUSIONS
Caring of children is a universal practice but there is a need of special care for children living with HIV. The majority of caregivers who were usually the mothers perceived the burden and need to be assisted in caring for the child. Stigma and discrimination with HIV infection further increased the burden as caregivers did not disclose the HIV status to any near and dear one.
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.
Ramesh Chand
RC
Chauhan
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Sanjay Kumar
SK
Rai
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Shashi
S
Kant
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Rakesh
R
Lodha
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Nand
N
Kumar
Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Puducherry, India.
Neelima
N
Singh
Caregiver; acquired immune deficiency syndrome (AIDS); children; human immunodeficiency virus (HIV)