CHILDREN'S POVERTY AND MORBIDITY OVERRIDE AIDS-RELATED ORPHANHOOD IN PREDICTING STIGMA AND BULLYING

Pantelic, M., Langhaug, L., Moonga F.,Wespi, K., Ammann, P., and Gschwend, A.

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UNICEF 2012

55,100 orphans in sub-Saharan Africa

15,000 HIV/AIDS-related orphans

BACKGROUND

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Stigma,

bullying

Familial HIV/AIDS

Poverty

Morbidity

MULTIPLE ADVERSITIES FACING ORPHANS

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Stigma

Depression

Anxiety

Bullying

Depression

Anxiety

PTS

Conduct problems

Suicide ideation + attempts

REPERCUSSIONS OF STIGMATIZATION AND BULLYING

Boyes & Cluver 2013, Boyes et al. 2014, Geel et al. 2014

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Little known about what factors stigmatize orphans•Existing research identifies AIDS-related orphanhood as a key stigmatizing marker (Boyes & Cluver 2013)

•Limited programmatic implications•Other markers?

Interventions should be sensitive to the needs of orphans

RESEARCH RATIONALE

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How are 3 stigma markers associated with perceived stigma and bullying victimization in Zambian orphans?

RESEARCH QUESTION

AIDS-related

orphanhoodPoverty Morbidity

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Cross-sectional survey (n=957)•Swiss Academy for Development

Total population sampling of orphaned adolescents (n=484)•ChildFund Zambia registers

5 communities in Kafue District, Zambia

Ethics approval obtained from University of Zambia

Same-sex face-to-face interviews

METHOD

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Stigma: brief Stigma-by-Association scale (Boyes et al. 2012)

Bullying victimization: adapted Multidimensional Peer-Victimization Scale (Mynard & Joseph 2000)

Food insecurity: # of days without food in the past week (Makame et al. 2002, Cluver et al. 2009)

Physical health: past month frequency of somatic complaints

AIDS-related orphanhood: verbal autopsy (WHO 2005)

MEASURES

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15 % lost parent due to HIV/AIDS

25 % reported hunger for 2+ days in past wk

56 % reported 3+ somatic complaints in past mo

72 % reported any perceived stigma

89 % reported any bullying victimization

DESCRIPTIVE RESULTS (ORPHAN SAMPLE)

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  Perceived Stigma

Bullying Victimization

  Standardized β Standardized β

Orphaned by AIDS .02 .01

Poor health .17*** .22***

Food insecurity .23*** .16***

***denotes significance at p<.001 adjusting for age and gender

RESULTS

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Together, poor health and food insecurity accounted for:

•10.3 % (R2 change =.103) of the variation in perceived stigma

•9.1 % (R2 change = .091) of the variation in bullying victimization

RESULTS

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Orphan stigma and bullying scores by food insecurity and health

RESULTS

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AIDS-related orphanhood NOT associated with stigma or bullying victimization in our sample

Extreme poverty and morbidity were associated with stigma and bullying of orphans.

Potential for: •Poverty alleviation and health promotion programs•Whole-school approaches (Vreeman and Carroll 2007)

SUMMARY & IMPLICATIONS

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Encouraging note:

We might not be able to change parental cause of death, but we can affect child poverty and health.

SUMMARY & IMPLICATIONS

THANK YOU

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Do orphan poverty and ill health mediate a link between AIDS-related orphanhood and stigma and bullying?

Univariate regressions to check whether AIDS-related orphanhood predicts stigma and/or bullying independently of orphan poverty and orphan health

Again, no associations between AIDS-related orphanhood and the two outcomes were found

No mediation pathway

POST HOC CONFIRMATORY ANALYSIS

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InterVA software, probabilistic epidemiological model

Standard WHO model

DETERMINING PARENTAL CAUSE OF DEATH