HIV-Associated Orphanhood and Children's Psychosocial Distress: Theoretical Framework Tested With Data From Zimbabwe

The researchers undertook the current study to measure the psychosocial effect of orphanhood in a sub-Saharan African population, and they evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children.

Data from 5,321 children ages 12 to 17 who were interviewed in a 2004 national survey in Zimbabwe were used to evaluate the framework. The researchers used principle components analysis to construct a measure of psychosocial distress, and they performed regression analyses to obtain standardized parameter estimates of psychosocial distress and odds ratios of early sexual activity.

The results showed that orphans had more psychosocial distress than did non-orphans. Paternal, maternal, and double orphans exhibited more severe distress than non-orphaned, non-vulnerable children, and this held true for both genders. Even after controlling for differences in more proximate determinants, orphanhood remained associated with psychosocial distress. Compared to non-orphaned, non-vulnerable children, maternal and paternal orphans were significantly more likely to have engaged in sexual activity; however, these differences were reduced after controlling for psychosocial distress.

"Orphaned adolescents in Zimbabwe suffer greater distress than do non-orphaned, non-vulnerable children, which may lead to increased likelihood of early onset of sexual intercourse and HIV infection," the researchers concluded, adding that the effect of psychosocial support strategies should be evaluated scientifically.