Barcelona 2013
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| Abstract #530 - Psychological state | ||||
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Session: 6.2: Psychological state (Parallel) on Monday @ 11.00-13.00 in Auditorio Chaired by Barbara Hedge, Susannah Allison Authors: Presenting Author: Ms Sarah Skeen - Stellenbosch University, South Africa |
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| Additional Authors: | ||||
| Aim: Research shows that children affected by HIV/AIDS are at risk for poor social, emotional and mental health outcomes. Interventions to address these should be evidence-based, yet a systematic review in 2009 could not identify a single study meeting quality standards for inclusion (King et al, 2009). This resulted in increased attention on programme evaluation. The aim of this study was to repeat the systematic review, 4 years later, to inform the evidence base on effective interventions for psychosocial outcomes of children affected by HIV. | ||||
| Method / Issue: Electronic databases were systematically searched using pre-defined terms drawn from the previous review. We included randomised controlled trials, crossover trials, cluster-randomised trials and factorial trials of psychological therapies, psychosocial interventions, medical interventions and social interventions. Studies had to measure psychosocial well-being, using validated measures. There were 1295 abstracts identified from Medline,Psychoinfo, Embase, Cochrane, Social Science Citation Index and International Bibliography of the Social Sciences. After removal of duplicates (360) and exclusions (853), 73 papers were reviewed in full text, and 22 met the inclusion criteria. Data extraction from the 22 included papers was standardised and checked by two reviewers. | ||||
| Results / Comments: The review process identified 22 published articles providing data from 15 intervention studies. Thirteen were in low resource settings. Most included adolescents; only 5 included participants under 9 years. Interventions were highly diverse, including conditional cash transfers, schooling support, home-visiting, health education, and mentoring /support groups. Outcomes measured included sexual behaviour, mental health, substance use, self-efficacy, self-esteem, nutrition, education, social support, early marriage, and HIV knowledge and stigma. Interventions which provided school-based support resulted in lower drop-out rates, improved self-efficacy and social skills. Group-based interventions affected mental health, substance use, self-efficacy, and HIV knowledge/attitudes. Home visiting interventions resulted in improved nutritional outcomes. Every study reported at least one significant positive finding of the intervention described. | ||||
| Discussion: Research in this area is growing rapidly and there is now some promising evidence for interventions to improve psychosocial outcomes in children affected by HIV/AIDS. However, studies have employed highly diverse interventions (often consisting of multiple components) and outcome measurement, making it difficult to draw conclusions, understand causal pathways or deconstruct elements of complex interventions. Given these differences, meta-analysis was not possible. There are still limited studies which have included young children as participants. There is a need for a comprehensive research agenda and ongoing study of improving outcomes for children affected by HIV/AIDS so that evidence-based programming can be developed and implemented. | ||||
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