Abstract #95  -  An evaluation of a community-based art therapy and education intervention for children affected by HIV in South Africa
Authors:   Presenting Author:   Ms Joanne Mueller - UCL
Additional Authors:  Prof Lorraine Sherr, Mr Collin Alie, Ms Beatrice Jonas, Ms Elizabeth Brown,
Aim: HIV infection, illness and death in the family can have a dramatic effect on the psychological and developmental capacities of children. Many interventions have mushroomed, but few are subjected to systematic evaluation. This study reports on a controlled evaluation of the MADaboutART programme (Knysna, South Africa), an art-based therapy and education intervention for HIV infected and affected children that aims to improve psychosocial health by increasing child self-efficacy and self-esteem. Delivered by trained community youth, interventions such as MAdaboutART are replicable and scalable at low cost and are associated with significant child benefits.
Method / Issue: A group of 297 children participated in the study. Of the 210 in the intervention arm, 177 (84%) responded and 120 were drawn as a control group from the same geographic, socioeconomic and age band. Children completed an inventory comprising cross-culturally validated and standardised psychosocial, emotional and developmental measures including the Strengths and Difficulties Questionnaire (SDQ), the Rosenberg Self Esteem Scale, and the Muris (2001) Child Self-Efficacy Scale, comprising social and emotional efficacy. Socio-demographic data, self-reported HIV infection stigma, and bereavement data was also collected.
Results / Comments: The sample comprised 143 female and 154 male participants, of whom 8.1% reported AIDS in their family and 7.4% self reported HIV infection; 4.7% were unsure if they were infected. In the intervention group, 7% reported a maternal death, 14% a paternal death and 5% had both parents deceased. In the control group, 6% reported a maternal death, 8% a paternal death and 6% had both parents deceased. Children attending the art intervention reported significantly more positive behaviours (t=2.4 p<0.05) and higher overall self-efficacy (t=2.3 p<0.05), higher social self-efficacy (t=2.6 p<0.01), and a trend for emotional self-efficacy (t=1.7 p=0.09). There were no differences by group on items on the Strengths and Difficulties Questionnaire, or on the Rosenberg Self Esteem Scale. Children attending the intervention were significantly more likely to look after other children at home (92% vs. 62.6% x2=5.2 p<0.05) although there was no difference in the rate of looking after unwell adults (both groups reported such care at 68%). Children attending the intervention group also were significantly less likely to report witnessing physical violence at home (34% vs. 46%; x2=4.3 p=0.05).
Discussion: In this area of high HIV prevalence, many children experience parental illness and death. The provision of expressional art and education from MADaboutART is significantly associated with children's higher self-efficacy in both the social and emotional domains. Children are carrying caring and bereavement burdens and interventions that allow self-expression and emotional care whilst developing self-efficacy should be supported.
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