Methods: We analyzed baseline data from the Suubi-Maka (hope for families) study to investigate the prevalence of emotional and behavioral difficulties and prosocial behavior (outcomes) using the SDQ. We applied ≥80th percentile for emotional and behavioral difficulties and ≥20th percentile for prosocial behavior as cutoff points for determining positive and negative cases to compute prevalence rates. Child psychological functioning including depressive symptoms, hopelessness, self-concept, and other sociodemographic characteristics were considered risk factors. Logistic regression models were used to investigate risk and protective factors associated with the mental health outcomes.
Results: Approximately 22.5% of participants had emotional symptoms, 32.4% had conduct problems, 25.7% had peer relationship problems, 24.3% had hyperactivity, and 23.7% had difficulties based on total score. Conversely, 80.4% had prosocial behavior. Higher caregiver mental health scores were associated with psychological difficulties among adolescents. Specifically, for every one unit increase in caregiver mental health score, the odds of adolescents having emotional and behavioral difficulties increased by 2% to 5%. Double orphanhood was associated with peer relationship problems (aOR = 2.47; 1.29, 4.77) and higher depressive symptoms score was associated with increased odds of hyperactivity (aOR = 1.06; 1.01, 1.12). Caregivers’ savings decreased the odds of emotional and behavioral problems and peer relationship problems, by 50% and 55%, respectively.
Conclusions: This study revealed high prevalence of emotional and behavioral difficulties among adolescents orphaned by AIDS and caregiver mental health problems are important risk factors for these difficulties. Thus, a holistic approach that simultaneously addresses caregiver mental health and child emotional and behavioral difficulties is imperative. Conversely, having savings was an important protective factors against emotional and behavioral difficulties suggesting interventions focused on family-level economic empowerment and family strengthening may be useful tools to address mental health outcomes among adolescents.