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Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: A structural equation modeling analysis

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  • Wang, Bo
  • Li, Xiaoming
  • Barnett, Douglas
  • Zhao, Guoxiang
  • Zhao, Junfeng
  • Stanton, Bonita

Abstract

Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6–18 years in 2006–2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors.

Suggested Citation

  • Wang, Bo & Li, Xiaoming & Barnett, Douglas & Zhao, Guoxiang & Zhao, Junfeng & Stanton, Bonita, 2012. "Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: A structural equation modeling analysis," Social Science & Medicine, Elsevier, vol. 74(9), pages 1435-1443.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:9:p:1435-1443
    DOI: 10.1016/j.socscimed.2012.01.007
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    References listed on IDEAS

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    1. Atwine, Benjamin & Cantor-Graae, Elizabeth & Bajunirwe, Francis, 2005. "Psychological distress among AIDS orphans in rural Uganda," Social Science & Medicine, Elsevier, vol. 61(3), pages 555-564, August.
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    5. Nyambedha, Erick Otieno & Wandibba, Simiyu & Aagaard-Hansen, Jens, 2003. "Changing patterns of orphan care due to the HIV epidemic in western Kenya," Social Science & Medicine, Elsevier, vol. 57(2), pages 301-311, July.
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    Cited by:

    1. 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.
    2. Butcher, Fredrick & Galanek, Joseph D. & Kretschmar, Jeff M. & Flannery, Daniel J., 2015. "The impact of neighborhood disorganization on neighborhood exposure to violence, trauma symptoms, and social relationships among at-risk youth," Social Science & Medicine, Elsevier, vol. 146(C), pages 300-306.

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