The Effects of Parental Loss on Psychosocial Wellbeing of AIDS-Orphaned Children Living in AIDS-Impacted Communities: Does Gender Matter?

Background and Purpose:The HIV/AIDS pandemic in sub-Saharan Africa continue to significantly contribute to the problem of orphaned children (defined as those who have lost one or both parents to HIV/AIDS). One of the sub-Saharan African countries hardest hit by the HIV/AIDS pandemic, Uganda, is estimated to have over 2.7 million orphaned children, with 1.2 million of them directly resulting from HIV/AIDS (UNICEF, 2013). Although orphaned children experience multiple and multidimensional stressors and disadvantages, given the culture and traditions of sub-Saharan Africa which prefer boys to girls, orphaned girls are particularly considered to be at a higher disadvantage, in regards to social isolation, early sexual activity including early marriages and are more likely to be taken out of school to perform care giving roles than boys. However, very few empirical studies have examined gender differences among AIDS-orphans. Yet gender perspectives could provide important information needed to facilitate meaningful and equitable service delivery for orphaned children. The purpose of this study therefore, is to examine gender and the effects of parental loss on psychosocial wellbeing of AIDS-orphaned children in communities heavily affected by HIV/AIDS in Uganda.

Methods: This study uses baseline data from a NICHD funded study, called Bridges to the Future(2011-2016), implemented in Uganda. A total of 1410 AIDS-orphaned children (n=625 boys, and n=785 girls), with an average age of 12.7 (range 10-16) participated in the study. Binary logistic regression analyses were conducted to examine: 1) the relationship between gender and the reported changes in the children’s lives following parental loss; and 2) the relationship between gender and the effects of parental loss on children’s feelings. We control for children’s age, orphanhood status and household composition.

Results:Study findings indicate that both boys and girls reported high levels of sadness, isolation, being scared, angry and worried following parental loss. Controlling for socio-demographic characteristics, parental loss affect boys and girls differently. Specifically, girls were more likely than boys to report taking on additional household responsibilities, such as taking of a parent (OR=1.3, 95% CI=1.0, 1.7, p<. 05), taking care of small children (OR=1.38, 95% CI=1.1, 1.8, p<. 01), and starting school late (OR=1.47, 95% CI=1.1, 1.8, p<. 01). Girls were also more likely to report having less food and money within their families (OR=1.4, 95% CI=1.1-1.9, p<. 01) and feeling scared (OR=1.33, 95% CI=1.0, 1.8, p<. 05) compared to boys.

Conclusion and Implications: Our findings suggest that in communities heavily affected by HIV/AIDS, parental loss has significant negative effects including socio-economic effects and psychosocial distress on children –especially girls. Additional efforts are needed to ensure that the psychosocial needs of orphaned children are met over and above the socio-economic support they currently receive from their families and communities. Special attention should be paid to the girl-orphaned child, to enable them carry out their caregiving roles without adverse impact on their own wellbeing.