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HIV-associated orphanhood and children's psychosocial distress: Theoretical framework tested with data from Zimbabwe

Author

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  • Nyamukapa, C.A.
  • Gregson, S.
  • Lopman, B.
  • Saito, S.
  • Watts, H.J.
  • Monasch, R.
  • Jukes, M.C.H.

Abstract

Objectives. We measured the psychosocial effect of orphanhood in a sub-Saharan African population and evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children. Methods. The framework was evaluated using data from 5321 children aged 12 to 17 years who were interviewed in a 2004 national survey in Zimbabwe. We constructed a measure of psychosocial distress using principle components analysis. We used regression analyses to obtain standardized parameter estimates of psychosocial distress and odds ratios of early sexual activity. Results. Orphans had more psychosocial distress than did nonorphans. For both genders, paternal, maternal, and double orphans exhibited more-severe distress than did nonorphaned, nonvulnerable children. Orphanhood remained associated with psychosocial distress after we controlled for differences in more-proximate determinants. Maternal and paternal orphans were significantly more likely than were nonorphaned, nonvulnerable children to have engaged in sexual activity. These differences were reduced after we controlled for psychosocial distress. Conclusions. Orphaned adolescents in Zimbabwe suffer greater psychosocial distress than do nonorphaned, nonvulnerable children, which may lead to increased likelihood of early onset of sexual intercourse and HIV infection. The effect of strategies to provide psychosocial support should be evaluated scientifically.

Suggested Citation

  • Nyamukapa, C.A. & Gregson, S. & Lopman, B. & Saito, S. & Watts, H.J. & Monasch, R. & Jukes, M.C.H., 2008. "HIV-associated orphanhood and children's psychosocial distress: Theoretical framework tested with data from Zimbabwe," American Journal of Public Health, American Public Health Association, vol. 98(1), pages 133-141.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2007.116038_3
    DOI: 10.2105/AJPH.2007.116038
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    1. Hagen, Jens & Omar Mahmoud, Toman & Trofimenko, Natalia, 2010. "Orphanhood and critical periods in children's human capital formation: Long-run evidence from North-Western Tanzania," Kiel Working Papers 1649, Kiel Institute for the World Economy (IfW Kiel).
    2. Kumakech, Edward & Cantor-Graae, Elizabeth & Maling, Samuel & Bajunirwe, Francis, 2009. "Peer-group support intervention improves the psychosocial well-being of AIDS orphans: Cluster randomized trial," Social Science & Medicine, Elsevier, vol. 68(6), pages 1038-1043, March.
    3. Hy V Huynh & Susan P Limber & Christine L Gray & Martie P Thompson & Augustine I Wasonga & Vanroth Vann & Dafrosa Itemba & Misganaw Eticha & Ira Madan & Kathryn Whetten, 2019. "Factors affecting the psychosocial well-being of orphan and separated children in five low- and middle-income countries: Which is more important, quality of care or care setting?," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-12, June.
    4. Cluver, Lucie & Orkin, Mark & Boyes, Mark E. & Sherr, Lorraine & Makasi, Daphne & Nikelo, Joy, 2013. "Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model," Social Science & Medicine, Elsevier, vol. 87(C), pages 185-193.
    5. Kaggwa, Esther B. & Hindin, Michelle J., 2010. "The psychological effect of orphanhood in a matured HIV epidemic: An analysis of young people in Mukono, Uganda," Social Science & Medicine, Elsevier, vol. 70(7), pages 1002-1010, April.
    6. Mark Lee & Elizabeth Heger Boyle, 2021. "Disciplinary practices among orphaned children in Sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-20, February.
    7. Fournier, Bonnie & Bridge, Andrea & Pritchard Kennedy, Andrea & Alibhai, Arif & Konde-Lule, Joseph, 2014. "Hear our voices: A Photovoice project with children who are orphaned and living with HIV in a Ugandan group home," Children and Youth Services Review, Elsevier, vol. 45(C), pages 55-63.
    8. Hagen, Jens & Omar Mahmoud, Toman & Trofimenko, Natalia, 2010. "Orphanhood and Critical Periods in Children's Human Capital Formation: Long-Run Evidence from North-Western Tanzania," Proceedings of the German Development Economics Conference, Hannover 2010 33, Verein für Socialpolitik, Research Committee Development Economics.
    9. Campbell, Catherine & Andersen, Louise & Mutsikiwa, Alice & Pufall, Erica & Skovdal, Morten & Madanhire, Claudius & Nyamukapa, Connie & Gregson, Simon, 2015. "Factors shaping the HIV-competence of two primary schools in rural Zimbabwe," International Journal of Educational Development, Elsevier, vol. 41(C), pages 226-236.
    10. Birdthistle, Isolde & Floyd, Sian & Nyagadza, Auxillia & Mudziwapasi, Netsai & Gregson, Simon & Glynn, Judith R., 2009. "Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe?," Social Science & Medicine, Elsevier, vol. 68(10), pages 1810-1818, May.
    11. Rachel Goldberg, 2013. "Family Instability and Early Initiation of Sexual Activity in Western Kenya," Demography, Springer;Population Association of America (PAA), vol. 50(2), pages 725-750, April.
    12. Rachel Goldberg & Susan Short, 2012. "“The Luggage that isn’t Theirs is Too Heavy…”: Understandings of Orphan Disadvantage in Lesotho," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 31(1), pages 67-83, February.

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