Abstract #25  -  Care arrangement of AIDS orphans and children's psychosocial well-being: evidence from rural China
Authors:   Presenting Author:   Dr. Xiaoming Li - Wayne State University School of Medicine
Additional Authors:  Dr. Yan Hong, Dr. Xiaoyi Fang, Dr. Xiuyun Lin, Dr.  Guoxiang Zhao, Dr. Junfeng Zhao,
Aim: Background/Objective: There were an estimated 15 million children orphaned by AIDS worldwide by 2003, and such number could reach 40 million by 2010. Developing an appropriate care arrangement for these children has been a challenging and important aspect of AIDS care effort. Existing literature regarding care-arrangement for AIDS orphans are rather limited and inconclusive. Given the limitation of data on care-arrangement of AIDS orphans worldwide and particularly a lack of such data in China, we conducted this study to examine the relationship between AIDS orphansĄŻ care arrangement and their psychosocial wellbeing among a sample of AIDS orphans in rural China.
Method / Issue: Methods: Cross-sectional data were obtained from 296 double AIDS orphans aged 6 to 18 years from central China, where many children lost their parents to AIDS due to unhygienic blood/plasma collection in 1980s-1990s. Among the participants, 176 were recruited from government-funded AIDS orphanages, 30 from community-based small group homes, and 90 from extended family or kinship care. Multivariate analyses were employed to examine the effect of care-arrangement on orphansĄŻ traumatic symptoms (anxiety, depression, anger, posttraumatic stress, dissociation, and sexual concerns), physical health (perceived health status, number of illnesses in the past month), and schooling (academic performance and educational aspiration).
Results / Comments: Results: The AIDS orphans in group homes reported the best outcomes in three domains of psychosocial wellbeing (less traumatic symptoms, better perceived health, fewer incidences of illness, and better school performance), followed by orphans in orphanages. The orphans in kinship care reported worst psychological health (e.g., the highest traumatic symptoms), physical health and school performance. The differences of outcome measures among three groups of children remained significant after controlling for key demographic factors.
Discussion: Discussion: The appropriate care arrangement for AIDS orphans should be evaluated within the specific social and cultural context where the orphans live. In resource-poor regions or areas stricken hardest by the AIDS epidemic, kinship care may not sufficiently serve the needs of AIDS orphans. The inferior health outcomes among orphans in kinship care may be due to inadequate care and attention from extended families that usually had limited resources or care-giving capacity in poverty-stricken areas such as the one in the current study. Care for AIDS orphans need to be a spectrum utilizing different kinds of resources from international donors, central and local governments, communities, and extended families. Community-based care models, with appropriate government and community support, preserving the family style and low child-to-caregiver ratio, may be an effective and sustainable care model for the best interest of the AIDS orphans. The future study needs to identify the protective factors in the group home setting so they can be developed for AIDS orphans in other care arrangement.
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