Poverty, AIDS and child health: Identifying highest-risk children in South Africa

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dc.contributor.authorCluver, Lucie
dc.contributor.authorBoyes, Mark
dc.contributor.authorOrkin, Mark
dc.contributor.authorSherr, Lorraine
dc.date.accessioned2021-10-08T07:18:07Z
dc.date.available2021-10-08T07:18:07Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. OBJECTIVES: To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. METHODS: We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. RESULTS: Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness. CONCLUSIONS: The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all.
dc.identifier.apacitationCluver, L., Boyes, M., Orkin, M., & Sherr, L. (2013). Poverty, AIDS and child health: Identifying highest-risk children in South Africa. <i>South African Medical Journal</i>, 103(12), 910 - 177. http://hdl.handle.net/11427/34908en_ZA
dc.identifier.chicagocitationCluver, Lucie, Mark Boyes, Mark Orkin, and Lorraine Sherr "Poverty, AIDS and child health: Identifying highest-risk children in South Africa." <i>South African Medical Journal</i> 103, 12. (2013): 910 - 177. http://hdl.handle.net/11427/34908en_ZA
dc.identifier.citationCluver, L., Boyes, M., Orkin, M. & Sherr, L. 2013. Poverty, AIDS and child health: Identifying highest-risk children in South Africa. <i>South African Medical Journal.</i> 103(12):910 - 177. http://hdl.handle.net/11427/34908en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Cluver, Lucie AU - Boyes, Mark AU - Orkin, Mark AU - Sherr, Lorraine AB - BACKGROUND: Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. OBJECTIVES: To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. METHODS: We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. RESULTS: Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness. CONCLUSIONS: The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 12 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2013 SM - 0038-2469 T1 - Poverty, AIDS and child health: Identifying highest-risk children in South Africa TI - Poverty, AIDS and child health: Identifying highest-risk children in South Africa UR - http://hdl.handle.net/11427/34908 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34908
dc.identifier.vancouvercitationCluver L, Boyes M, Orkin M, Sherr L. Poverty, AIDS and child health: Identifying highest-risk children in South Africa. South African Medical Journal. 2013;103(12):910 - 177. http://hdl.handle.net/11427/34908.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Psychiatry and Mental Health
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue12
dc.source.journalvolume103
dc.source.pagination910 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.7045
dc.subject.otherHumans
dc.subject.otherAcquired Immunodeficiency Syndrome
dc.subject.otherRisk Assessment
dc.subject.otherRisk Factors
dc.subject.otherRandom Allocation
dc.subject.otherChild Development
dc.subject.otherMental Health
dc.subject.otherMental Disorders
dc.subject.otherQualitative Research
dc.subject.otherPoverty
dc.subject.otherChild Welfare
dc.subject.otherNeeds Assessment
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherChild
dc.subject.otherChild of Impaired Parents
dc.subject.otherSouth Africa
dc.subject.otherFemale
dc.subject.otherMale
dc.subject.otherChild, Orphaned
dc.titlePoverty, AIDS and child health: Identifying highest-risk children in South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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