Studies show elevated levels of psychological distress among acquired immune
deficiency syndrome (AIDS)-orphaned children. Caregiving factors are critical in
child mental health, but little is known about their effects among AIDS-orphaned
children. This study aimed to explore whether caregiving factors (e.g. caregiver
illness, monitoring and abuse) mediated between orphanhood status and psychological
problems. A total of 1025 children and adolescents (aged 10–19 years), living
in South African urban informal settlements, were interviewed using
sociodemographic questionnaires and standardized psychological scales of depression,
anxiety, post-traumatic stress disorder, peer problems, delinquency and conduct
problems. AIDS-orphaned children (n = 425) were compared to control
groups of other-orphans (n = 241) and non-orphans (n = 278). Results showed that
child abuse, domestic violence, sibling dispersion and changes of caregiver were
associated with psychological problems for all children, but did not mediate
between orphanhood and psychological distress. AIDS-orphaned children reported
more caregiver illness and excessive housework, and these two factors mediated
the strong associations between psychological distress and AIDS-orphanhood.
These findings suggest that interventions addressing caregiver ill-health and supporting
young carers may have potential to ameliorate psychological distress
among AIDS-orphaned children