Correlates of Depression Among Caregivers of Children Orphaned by HIV/AIDS

Background: Although the prevalence of HIV/AIDS is on the decline in Sub-Saharan Africa the number of children affected the by disease continues to increase. While some orphaned children have been placed in institutions or orphanages, the uptake has been more evident in the integration of children into the extended family system (Kuo & Operario, 2009). One in every four families in Uganda provides care to children orphaned by HIV/AIDS (Uganda Ministry of Gender Labour and Social Development, 2006). These changing family structures are inadvertently coupled with mental stressors as caregivers struggle to cope with the added family responsibilities (Ssengonzi, 2007; UNICEF, 2007). Mental health is a largely understudied public health arena in Africa.

This study looked at the mental health status of caregivers of children affected by AIDS in Uganda. The study addressed the following fundamental questions 1) do caregivers of children orphaned by AIDS report depression symptomology; 2) is there a correlation between life conditions and depression.

Methods: The study used data from the SUUBI-MAKA family economic empowerment program. The program combines microfinance and health-promotion strategies to empower families providing care to AIDS orphans in Uganda. Life condition was operationalized with variables identified in the literature as having an association with depression (age, gender, social support, and family savings). Univariate analysis was used to describe the data. Pearson correlation, chi-square and regression analysis was employed to determine variable associations.

Results: Depression was scored on a scale of 0 to 44 (M= 13.4, SD= 8.04). The sample consisted of 297 caregivers with a mean age of 46 years (range 18-87 years). Approximately eighty percent were women, who were more likely to report higher depressive symptoms when compared to men t (294) =2.6; p =0.009.

Thirty five percent of the respondents had household savings with median savings reported at UGSHS 100,000 (equivalent to USD 48). Household savings ranged from UGSHS 10,000 to 4,000,000 (equivalent to USD 5 to 1905). Caregivers who reported having no savings had higher rates of depression symptoms t (295) = 2.66; p=0.008.

Social support was scored on a scale of 9 to 24. On average respondents indicated high levels of social support (M= 19.9, SD=3.6). Pearson correlation indicated a statistically significant association between social support and depression (r= -0.16; p=0.006).

The variables explained 6% of the OLS regression model f (294) 4.74; p=0.001. Social support was the only significant predictor in the model t= 2.51; p =0.013. For each unit increase in social support there was a 0.33 decrease in depression symptomology. Implications: In examining the correlates of self reported depressive symptoms this study provides a contextualized understanding of depression in low-income communities affected by HIV. Caregivers who are female, have no family savings, and those with minimal social support are more at risk of experiencing depression. Social work practitioners should focus on identifying and strengthening social support mechanisms available to families providing care to children affected by AIDS. In addition the findings underscore the need for family economic empowerment projects that facilitate savings and wealth creation.