237657 Mental Health of Children Affected by AIDS and their Carers in KwaZulu-Natal, South Africa

Tuesday, November 1, 2011

Caroline Kuo, DPhil , Department of Psychiatry and Alpert Medical School, Rhode Island Hospital and Brown University, Providence, RI
Lucie D. Cluver, DPhil , Department of Social Policy and Intervention, Oxford University, Oxford, United Kingdom
Marisa Casale, MSc , Health Economics and HIV/AIDS Research Division, University of KwaZulu Natal, Durban, South Africa
Tyler Lane, MSc , Department of Social Policy and Intervention/Health Economics and HIV/AIDS Research Division, University of Oxford/University of KwaZulu Natal, Oxford, United Kingdom
Don Operario, PhD , Department of Behavioral and Social Sciences, Brown University, Providence, RI
Background: Growing evidence suggests that HIV-affected children and their adult carers experience negative mental health outcomes. However, few studies family mental health dynamics in HIV-affected families. Additional evidence on family mental health dynamics can inform the design of interventions to protect family wellbeing in communities facing rising numbers of AIDS-related parental deaths.

Methods: A cross-sectional survey of 5,238 participants (2,619 children 10-17 years and their primary adult carers) was conducted in 2010 in KwaZulu-Natal (HIV prevalence 36.3-41.6%). Random sampling of census enumeration size areas was used and visits to all households undertaken. Depression and anxiety were assessed using validated tools with strong psychometric properties. Analyses tested correlations between carer and child health, differences in child mental health using chi-square, and multivariate regression controlled for sociodemographic differences in groups.

Results: Among carers, 44.4% met criteria for depression, anxiety, and/or PTSD. Among children, 23.1% met criteria for depression, anxiety, and/or PTSD. AIDS-affected children were more likely to report poor mental health outcomes than non-AIDS affected children (p<0.01). Independent of sociodemographic covariates, AIDS-affected children were at increased risk for poor mental health when living in a home where their carers reported poor mental health (p<0.01).

Conclusions: Preliminary findings indicate a strong relationship between carer and child mental health outcomes. Furthermore, children living in families affected by AIDS and where carers reported poor mental health were at increased risk for poor mental health outcomes. Interventions may need to target the family rather than individually targeting either the child or adult carer.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention

Learning Objectives:
1. Describe carer and child mental health outcomes in HIV-affected families. 2. Identify linkages in carer and child mental health. 3. Assess whether AIDS-affected children and children living with carers with poor mental health outcomes are at increased risk for poor mental health outcomes.

Keywords: Adult and Child Mental Health, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral fellow at Rhode Island Hospital/Brown University. I have given oral presentations at the last two APHA conferences.
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.

See more of: HIV/AIDS & Health Disparities
See more of: HIV/AIDS