Original articleEffects of Stigma on the Mental Health of Adolescents Orphaned by AIDS
Section snippets
Participants
The sample comprised 1025 children and adolescents: 425 were orphaned by AIDS, 241 orphaned by other causes, and 278 who were not orphaned. Eighty-one were excluded from analyses because of uncertainty regarding cause of parental death. The study used the UN definition of orphanhood as loss of one or both parents [4], and followed the World Health Organization definition of adolescence as 10 to 19 years [11]. To increase generalizability, we purposively sampled populations unlikely to be
Associations between orphanhood and community risk factors
Descriptive properties of the four measured community risk factors are described in Table 1. Overall levels of bullying and experience of community traumas were high, but showed no group differences. Significant group differences on stigma and positive activities were observed. One-way ANOVAs showed that AIDS orphans reported significantly more stigma than other orphans (p < .001), and that other orphans reported more stigma than nonorphans (p < .001). AIDS orphans were more likely to report
Discussion
This study highlights the emergence of a group at high risk of adverse psychological outcomes. AIDS-orphaned adolescents have been shown to be at particular risk for mental health problems of depression, peer problems, posttraumatic stress disorder, and behavior problems. Levels of anxiety showed no differences, perhaps reflecting the exceptionally high levels of community violence affecting most children in the study areas, irrespective of orphan group [23]. AIDS-orphaned children are also at
Conclusions
It is crucial that policies are developed to address psychological distress experienced by AIDS-orphaned adolescents. Although some factors addressable at a community level, such as reducing bullying and exposure to community trauma, and increasing positive activities, have potential to improve mental health more generally, AIDS-related stigma was shown to be particularly relevant to AIDS orphans, and to have strong predictive effects on psychopathology. It is essential that interventions are
Acknowledgments
This study was undertaken in collaboration between Oxford University and Cape Town Child Welfare Society. The study was made possible by support from the UK Economic and Social Research Council. The authors wish to thank the children who participated in the study, and their families, the participating schools and organizations, and interviewers. Also thanks to Brendan Maughan-Brown and Harriet Deacon. L. Cluver conceived of the study and conducted fieldwork and analyses. F. Gardner assisted
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