title: Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.
abstract: Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.
authors: Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
authors: Estella
authors: E
authors: Nduwimana
authors: Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
authors: Sylvere
authors: S
authors: Mukunzi
authors: FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors: Lauren C
authors: LC
authors: Ng
authors: Department Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, 12th Floor, Boston, MA, 02115, USA.
authors: Catherine M
authors: CM
authors: Kirk
authors: Rwinkwavu District Hospital, Ministry of Health, Rwinkwavu, Rwanda.
authors: Justin I
authors: JI
authors: Bizimana
authors: Department Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, 12th Floor, Boston, MA, 02115, USA. theresa_betancourt@harvard.edu.
authors: Theresa S
authors: TS
authors: Betancourt
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D002648:Child; D054540:Child, Orphaned / Q000523:psychology*; D003863:Depression / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D005581:Foster Home Care / Q000523:psychology*; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D016487:Parenting / Q000523:psychology; D012424:Rural Population; D012432:Rwanda / Q000453:epidemiology
keywords: Adolescents; Foster children; HIV; Mental health; Sub-Saharan Africa