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Health. Emerging Research. Our Motivation To Do Better For Children: Challenges Faced By Children Orphaned By AIDS. When a parent dies of AIDS, his or her child: Is more likely to face stigmatization, rejection, and a lack of love and care.

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Emerging Research

Our motivation to do better for children challenges faced by children orphaned by aids
Our Motivation To Do Better For Children: Challenges Faced By Children Orphaned By AIDS

When a parent dies of AIDS, his or her child:

  • Is more likely to face stigmatization, rejection, and a lack of love and care.

  • Often suffer from emotional distress, malnutrition, a lack of health care, and poor or no access to education.

  • AIDS orphans are also at high risk for labor exploitation, sex trafficking, homelessness, and exposure to HIV.

  • Increasingly, extended families and communities in highly affected areas find that their resources are inadequate to provide the basics for all needy children.

A closer look at the national picture
A Closer Look At The National Picture



HIV infection of Parents

How HIV Affects Children

Possible distancing by parent, disclosure issues

Children may become caregivers

Increasingly serious illness

Stigma & discrimination

Psychosocial distress

Economic problems

Deaths of parents

Problems with inheritance


Children withdraw from school

Children without adequate adult care

Inadequate food


Problems with shelter & material needs

Exploitative child labor

Sexual exploitation

Reduced access to health services


Increased vulnerability to HIV infection

Life on the street


Promoting Resilience

World’s First Longitudinal Study

  • Question: Are there long-term impacts of parental AIDS on child mental health, education, and sexual health?

  • Sampling

  • In 2005: N=1021 (ages 10-18)

  • In 2009: 71.5% follow up

  • Three provinces in South Africa

  • Comparing AIDS orphaned/other- orphaned/non-orphaned children

National young carers study 2009 2012
National Young Carers Study (2009-2012)

  • Questions:

  • How does parental AIDS-illness impact children?

  • Can social protection services improve outcomes?

  • Sampling

  • Main study: N-6000 (aged 10-18) + pilot: 850 children

  • Six randomly selected sites >30% prevalence, three provinces

  • Urban/rural, one-year follow up


What it Feels Like

“This is what I want to say to my parents: ‘My heart is broken. Things go wrong for me all the time. I am lonely. Please come back to me’.”

(boy, 10, urban area)

Cluver, L. and F. Gardner. 2007. AIDS Care 19(3): 318-325.


Child Education Difficulties

Cluver, L., D. Operario, T. Lane, and M. Kganakga. 2012. Journal of Adolescent Research.


Depression and Post-Traumatic Stress

Cluver, L., F. Gardner, and D. Operario. 2007. Journal of Child Psychiatry & Psychology, 48(8): 755-763.


Over time: AIDS-orphaned children get worse, faster

Cluver, L., M. Orkin, M. Boyes, and F. Gardner. 2011. Journal of Child Psychiatry and Psychology.


Anxiety and Depression Results

 Cluver, L., M. Orkin, M. Boyes, and F. Gardner. 2012. Journal of Pediatric Psychology.

Hunger and nutrition
Hunger and Nutrition

Cluver, L., F. Gardner, and D. Operario. 2009. AIDS Care 21 (6): 732-741.

Stigma and bullying
Stigma and Bullying

Cluver, L., F. Gardner, and D. Operario. 2008. Journal of Adolescent Health, 42 (4): 410-418.

Transactional sex
Transactional Sex

Sex for: Food


School fees



Cluver, L. et al. 2012. XIV International AIDS Conference, Washington DC.

Child abuse in the home
Child Abuse in the Home

Cluver, L. 2011. Nature, 474: 27-29.

Link to transactional sex
Link to Transactional Sex

Cluver, L, M Orkin, Boyes et al , (2011) ‘Transactional Sex amongst AIDS-orphaned & AIDS-Affected Adolescents Predicted by Abuse and Extreme Poverty’. JAIDS

Thinking about life changes for aids affected children
Thinking about life changes for AIDS-affected children

“I just couldn’t understand the way my life completed. I couldn’t accept that my mother is gone for good. I was pregnant. I left school. It was hard for me to accept that.”

(girl, 17, urban)

Additional research
Additional Research

  • Schenk, K.D., A. Michaelis, T.N. Sapiano, L. Brown, and E. Weiss, E. 2010. Improving the lives of vulnerable children: Implications of Horizons research among orphans and other children affected by AIDS. Public Health Reports, 125, 325-336.

  • Cluver, L., F. Gardner, and D. Operario, D. 2007. Psychological distress amongst AIDS-orphaned children in urban South Africa. Journal of Child Psychology and Psychiatry, 48, 755-763. for all their papers for free.

  • Atwine, B., E. Cantor-Graae, and F. Bajunirwe. 2005. Psychological Distress among AIDS orphans in rural Uganda. Social Science and Medicine, 61, 555-564.

  • Kumakech, E., E. Cantor-Graae, S. Maling, and F. Bajunirwe. (2009). Peer-group support intervention improves the psychosocial well-being of AIDS orphans: Cluster randomized trials. Social Science and Medicine, 68, 1038-1043.

  • Rotheram-Borus, M.J., J.A. Stein, and Y.Y. Lin. 2001. Impact of parent death and intervention on the adjustment of adolescents whose parents have HIV/AIDS. Journal of Consulting and Clinical Psychology, 69, 763-773.