207017 Caring for AIDS-orphaned children: Health outcomes of carers of AIDS-orphaned and other vulnerable children in South Africa

Monday, November 9, 2009: 8:45 AM

Caroline Kuo, MPhil , Department of Social Policy and Social Work, Oxford University, Oxford, United Kingdom
Don Operario, PhD , Department of Community Health, Brown University, Providence, RI
Lucie D. Cluver, PhD , Department of Social Policy and Social Work, Oxford University, Oxford, United Kingdom

Over one million AIDS-orphaned children live in South Africa. No known studies have assessed the health of carers of AIDS-orphaned children in the global South. This study aims to: (a) assess sociodemographic characteristics of carers in KwaZulu-Natal, the province with the highest HIV prevalence; (b) measure mental health outcomes.


A cross-sectional survey of 1312 adult primary caregivers was conducted in a high-deprivation urban area of Kwa-Zulu Natal. From August 2008-Feb 2009,Census Enumeration Areas were randomly selected and all homes surveyed to ensure a representative sample. Surveys included validated measures of general health, anxiety, depression, substance abuse, and post-traumatic stress.

Analyses tested group differences using Pearson's chi-square between AIDS-orphan (n=338), other-orphan (n=106), and non-orphan carers (n=850).


Participants were African, predominantly female (87%), with an average age of 39 years(sd=14). Overall, 64% showed moderate levels of anxiety and 32% exhibited clinically significant levels of depression exceeding national prevalence data from the South African Stress and Health Study (anxiety, 20.1% and mood, 10%). Other-orphan carers showed significantly higher anxiety and marginally higher depression than AIDS-orphan carers. Other-orphan carers showed significantly higher anxiety and depression than non-orphan carers. No significant differences were found comparing AIDS-orphan to non-orphan carers.


This is the first known representative study to examine the health of carers of AIDS-orphaned children and other vulnerable children. We found elevated levels anxiety and depression overall, and disparities among orphan carers. Targeted public health interventions must address risk and vulnerability for orphan carers.

Learning Objectives:
1) Describe the social and epidemiological context for public health risk outcomes among carers for AIDS-orphaned children in South Africa; 2)Assess levels of public health and psychological risk outcomes among a representative sample of carers in South Africa; and, 3)Identify health disparities for carers of AIDS-orphaned children in South Africa.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have researched carers of AIDS-orphaned children for the past four years. Prior to researching carers of AIDS-orphaned children, I have conducted research on public health issues for seven years, first with research at the US Centers for Disease Control and Prevention and at the Lewin Group focusing on health policy and health programs affecting vulnerable populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.