An Ecological Approach to the Understanding of Social Support and Mental Health among South African Children Affected by AIDS
Children affected by HIV have significantly higher levels of negative mental health outcomes. These children are either orphaned or live with an HIV positive family member. Many have witnessed caregiver illness and familial death at a young age. This loss of support impacts psychological well-being throughout their lifetime. Nonetheless, there is limited research focusing on the well-being of particular group of children. The study utilized secondary analysis of data derived from the Young Carers research study where 3,516 children (ages 10-19) were interviewed at the 2011 follow-up. Of these 1,380 were classified as either orphaned by AIDS and/or living with an AIDS sick family member. All children were from high-poverty and high HIV prevalent rural and urban communities in Mpumalanga and Western Cape Provinces, South Africa. This research analyzed the different sources and types of social support to tease out specific factors related to resilience and to identify predictors of positive mental health. Using the ecological model as a frame, the research examined social support sources within the child's family, peers, and community in tandem with social support type (emotional, financial, and satisfaction). Bivariate and multivariate analyses were used to estimate regression models to identify variables related to depression, anxiety, and PTS symptoms. Several social support source and type variables emerged as predictors of children's well-being in the context of HIV, in particular reinforcing the fact that family is the main provider of social support, and highlighting the importance of siblings in relation to children affected by HIV and AIDS. Findings suggest that social workers and other professionals should consider social support from a number of sources, but in particular look more closely at the peer and sibling group relationships among children affected by HIV and AIDS, which can foster the resilience of this vulnerable group. Furthermore, social workers, providers, and policy makers are urged to leverage these mechanisms of support to improve the mental health and resiliency of children. HIV interventions should integrate regular mental health screenings and referrals as a standard of care for all children affected by HIV and AIDS.
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