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    Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model

    195667_103826_09_-_2013_Social_Science_and_Medicine.pdf (511.3Kb)
    Access Status
    Open access
    Authors
    Cluver, L.
    Orkin, M.
    Boyes, Mark
    Sherr, L.
    Makasi, D.
    Nikelo, J.
    Date
    2013
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Cluver, Lucie and Orkin, Mark and Boyes, Mark E. and Sherr, Lorraine and Makasi, Daphne and Nikelo, Joy. 2013. Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model. Social Science and Medicine. 87: pp. 185-193.
    Source Title
    Social Science and Medicine
    DOI
    10.1016/j.socscimed.2013.03.028
    ISSN
    0277-9536
    Remarks

    This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/. Please refer to the licence to obtain terms for any further reuse or distribution of this work.

    URI
    http://hdl.handle.net/20.500.11937/24696
    Collection
    • Curtin Research Publications
    Abstract

    Increasing evidence demonstrates negative psychological, health, and developmental outcomes for children associated with parental HIV/AIDS illness and death. However, little is known about how parental AIDS leads to negative child outcomes. This study used a structural equation modelling approach to develop an empirically-based theoretical model of interactive relationships between parental or primary caregiver AIDS-illness, AIDS-orphanhood and predicted intervening factors associated with children's psychological distress, educational access and sexual health. Cross-sectional data were collected in 2009–2011, from 6002 children aged 10–17 years in three provinces of South Africa using stratified random sampling. Comparison groups included children orphaned by AIDS, orphaned by other causes and non-orphans, and children whose parents or primary caregivers were unwell with AIDS, unwell with other causes or healthy. Participants reported on psychological symptoms, educational access, and sexual health risks, as well as hypothesized sociodemographic and intervening factors. In order to build an interactive theoretical model of multiple child outcomes, multivariate regression and structural equation models were developed for each individual outcome, and then combined into an overall model.Neither AIDS-orphanhood nor parental AIDS-illness were directly associated with psychological distress, educational access, or sexual health. Instead, significant indirect effects of AIDS-orphanhood and parental AIDS-illness were obtained on all measured outcomes. Child psychological, educational and sexual health risks share a common set of intervening variables including parental disability, poverty, community violence, stigma, and child abuse that together comprise chain effects. In all models, parental AIDS-illness had stronger effects and more risk pathways than AIDS-orphanhood, especially via poverty and parental disability. AIDS-orphanhood and parental AIDS-illness impact child outcomes through multiple, interlinked pathways. The interactive model developed in this study suggests key areas of focus for interventions with AIDS-affected children.

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