Gender and HIV-Related Stigma Among Caregivers of Children Orphaned By HIV/AIDS in Uganda

Background and Purpose: Child-caregiver relationship is critical to child and adolescent development. Specifically, it has been associated with better mental health and psychological wellbeing, social support, positive educational outcomes, as well as reduced risk-taking behaviors. However, in the face of HIV/AIDS, caregiver attitudes and HIV-related stigma, are two attributes that may affect caregiving roles as well as the quality of caregiving. Caring for individuals living with HIV has been associated with severe stress among family members and negatively affect family functioning. Moreover, family members may also perceive stigma due to their association with members living with HIV, including their children. Yet, few studies have examined HIV-related stigma among caregivers of children affected by HIV/AIDS. This study examines gender and HIV-related stigma among caregivers of children orphaned by HIV/AIDS in Southern Uganda.

Methods: This study utilized data from an NIH-funded Suubi-Maka (Hope for families) study that was implemented in Uganda. A total of 346 caregivers (n=71 males and n=275 females), with their children (dyads), participated in the study. HIV-related stigma was measured using 12-items that assess caregivers’ attitudes and beliefs towards people living with HIV. Bivariate and multiple linear regression analyses were conducted to ascertain the individual and family-level factors associated with HIV-related stigma among caregivers.

Findings: Of the total sample, 79.5% were female and 20.5% were males. The overall mean age was 45.7 (SD=14.61). Female caregivers reported higher scores on the stigma measure compared to male caregivers (mean = 29.10 versus 26.2). Results from multiple regression analysis indicate that age (b= 0.085, 95% CI=0.035, - 0.135, p<.05), gender (b= 2.284, 95% CI=0.511 – 4.056, p<.05), and family cohesion (b= 0.288, 95% CI= 0.059 – 0.517, p<.05), were associated with HIV related stigma among caregivers.

Implications and Conclusions: The caregiver-child relationship is central to a child's development. Our findings indicate that older caregivers, female caregiver and family cohesion were all significant predictors for HIV-related stigma among caregivers. HIV-related stigma among caregivers represents a double burden for children and adolescents, already growing up as orphans due to HIV/AIDS. Taken together, these findings point to the need to integrate family-level stigma reduction components in programing caring for children and families impacted by HIV in low resources settings, such as those in sub-Saharan Africa.