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Cumulative risk and AIDS-orphanhood: Interactions of stigma, bullying and poverty on child mental health in South Africa

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  • Cluver, Lucie
  • Orkin, Mark

Abstract

Research shows that AIDS-orphaned children are more likely to experience clinical-range psychological problems. Little is known about possible interactions between factors mediating these high distress levels. We assessed how food insecurity, bullying, and AIDS-related stigma interacted with each other and with likelihood of experiencing clinical-range disorder. In South Africa, 1025 adolescents completed standardised measures of depression, anxiety and post-traumatic stress. 52 potential mediators were measured, including AIDS-orphanhood status. Logistic regressions and hierarchical log-linear modelling were used to identify interactions among significant risk factors. Food insecurity, stigma and bullying all independently increased likelihood of disorder. Poverty and stigma were found to interact strongly, and with both present, likelihood of disorder rose from 19% to 83%. Similarly, bullying interacted with AIDS-orphanhood status, and with both present, likelihood of disorder rose from 12% to 76%. Approaches to alleviating psychological distress amongst AIDS-affected children must address cumulative risk effects.

Suggested Citation

  • Cluver, Lucie & Orkin, Mark, 2009. "Cumulative risk and AIDS-orphanhood: Interactions of stigma, bullying and poverty on child mental health in South Africa," Social Science & Medicine, Elsevier, vol. 69(8), pages 1186-1193, October.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:8:p:1186-1193
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    1. Jorge M. Aguero & Michael R. Carter & Ingrid Woolard, 2006. "The Impact of Unconditional Cash Transfers on Nutrition: The South African Child Support Grant," SALDRU Working Papers 8, Southern Africa Labour and Development Research Unit, University of Cape Town.
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    1. Ashley Turbeville & J. Lawrence Aber & Sharon L. Weinberg & Linda Richter & Alastair Heerden, 2019. "Childhood Economic Well-Being in South Africa: Construction of a Theoretically-Grounded Empirically-Derived Multidimensional Measure," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 12(6), pages 1855-1878, December.
    2. Gavan, Luana & Hartog, Kim & Koppenol-Gonzalez, Gabriela V. & Gronholm, Petra C. & Feddes, Allard R. & Kohrt, Brandon A. & Jordans, Mark J.D. & Peters, Ruth M.H., 2022. "Assessing stigma in low- and middle-income countries: A systematic review of scales used with children and adolescents," Social Science & Medicine, Elsevier, vol. 307(C).
    3. Li, Xiaoming & Harrison, Sayward E. & Fairchild, Amanda J. & Chi, Peilian & Zhao, Junfeng & Zhao, Guoxiang, 2017. "A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up," Social Science & Medicine, Elsevier, vol. 190(C), pages 256-264.
    4. Campbell, Catherine & Skovdal, Morten & Mupambireyi, Zivai & Gregson, Simon, 2010. "Exploring children's stigmatisation of AIDS-affected children in Zimbabwe through drawings and stories," Social Science & Medicine, Elsevier, vol. 71(5), pages 975-985, September.
    5. Dadan Erwandi & Abdul Kadir & Fatma Lestari, 2021. "Identification of Workplace Bullying: Reliability and Validity of Indonesian Version of the Negative Acts Questionnaire-Revised (NAQ-R)," IJERPH, MDPI, vol. 18(8), pages 1-22, April.
    6. 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.
    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. Kathryn Whetten & Jan Ostermann & Brian W Pence & Rachel A Whetten & Lynne C Messer & Sumedha Ariely & Karen O'Donnell & Augustine I Wasonga & Vanroth Vann & Dafrosa Itemba & Misganaw Eticha & Ira Mad, 2014. "Three-Year Change in the Wellbeing of Orphaned and Separated Children in Institutional and Family-Based Care Settings in Five Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    9. Trudell, John Paul & Burnet, Maddison L. & Ziegler, Bianca R. & Luginaah, Isaac, 2021. "The impact of food insecurity on mental health in Africa: A systematic review," Social Science & Medicine, Elsevier, vol. 278(C).
    10. 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.
    11. Betancourt, Theresa Stichick & Meyers-Ohki, Sarah & Stulac, Sara N. & Elizabeth Barrera, Amy & Mushashi, Christina & Beardslee, William R., 2011. "Nothing can defeat combined hands (Abashize hamwe ntakibananira): Protective processes and resilience in Rwandan children and families affected by HIV/AIDS," Social Science & Medicine, Elsevier, vol. 73(5), pages 693-701, September.
    12. Garman, E.C. & Avendano, Mauricio & Araya, Ricardo & Evans-Lacko, Sara & McDaid, David & Zimmerman, A. & Lund, C., 2022. "Understanding the complex relationship between multidimensional poverty and depressive symptoms among young South Africans: a cross-sectional study," LSE Research Online Documents on Economics 116674, London School of Economics and Political Science, LSE Library.
    13. Megan K Ramaiya & Kristen A Sullivan & Karen O' Donnell & Coleen K Cunningham & Aisa M Shayo & Blandina T Mmbaga & Dorothy E Dow, 2016. "A Qualitative Exploration of the Mental Health and Psychosocial Contexts of HIV-Positive Adolescents in Tanzania," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-13, November.

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