Abstract #153  -  Caring for AIDS-Orphaned Children: Varying Health Vulnerabilities Amoungst Carers
Authors:   Presenting Author:   Ms Caroline Kuo - University of Oxford, Nuffield College
Additional Authors:  Dr.  Don Operario, Dr.  Lucie Cluver,
Aim: The HIV/AIDS pandemic is one of the most urgent public health issues of our time, leaving in its wake an estimated 15 million AIDS-orphaned children globally. The orphan crisis is particularly urgent in South Africa, which faces the highest absolute number of people infected with HIV in the world and where an estimated 1.4 million children have lost one or both parents to AIDS. Whilst the scale of the problem is enormous, there is a critical gap in research on the sequelae of HIV/AIDS on carers of AIDS-orphaned children, a population that is directly and significantly affected by AIDS-related deaths. No known research has assessed health outcomes amongst a representative sample of adults caring for AIDS-orphaned children. This study sets out to: (a) assess sociodemographic characteristics of adults caring for AIDS-orphaned children in KwaZulu-Natal, the province with the highest HIV/AIDS prevalence in RSA; (b) measure mental health outcomes of carers; and (c) identify factors mediating upon the health of carers.
Method / Issue: A cross-sectional survey of adults (18 years and older) providing primary childcare in Umlazi township was conducted between August 2008 and February 2009. South African Census Enumeration Areas were randomly selected and all homes surveyed resulting in a representative sample of carers (n=1580). Surveys included standardized and validated measures of general health, anxiety, depression, substance abuse, and post-traumatic stress. Preliminary analyses included calculating summary statistics, assessing group differences between AIDS-orphan (n=377), non-AIDS-orphan (n=131), and non-orphan carers (n=1072) using Pearson chi-square test, one way ANOVA and post-hoc comparisons using Tukey, and testing associations to identify factors mediating upon health outcomes.
Results / Comments: Participants were African, predominantly female (86%), ranging in age from 18-90 years with an average age of 39 years (standard deviation=14). Overall, 62% showed moderate levels of anxiety and 30% exhibited clinically significant levels of depression exceeding national prevalence data from the South African Stress and Health Study (anxiety, 20.1% and mood, 10%). AIDS-orphan carers had the worst general health, followed by other-orphan carers and non-orphan carers respectively (13.314, df=2, p<0.000). Other-orphan carers showed significantly higher depression than non-orphans (4.630, df=2, p<0.010). No differences were shown in anxiety levels across groups.
Discussion: This is the first known representative study to examine the health of carers of AIDS-orphaned children and other vulnerable children. We found elevated levels of anxiety and depression overall, with levels of general health and depression varying significantly among different types of carers. Interventions designed to support the wellbeing of carers must address varying risk and vulnerability amongst orphan carers.
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