Abstract
We investigated the psychosocial well-being of children in HIV/AIDS-affected families in rural China from the child’s and caregiver’s perspectives. Semi-structured interviews were conducted among children living in HIV/AIDS-affected families (n = 16), their caregivers (n = 16) and key community informants (n = 5). Our findings showed that all of the children relied heavily on caregivers and peers to gain psychological support. Children’s psychosocial problems included fear, anxiety, grief, and loss of self-esteem and confidence. Stigma towards children existed, including isolation, ignorance and rejection. Our study illustrates that HIV/AIDS has impacted negatively on the psychosocial well-being of children. These findings can be used as preliminary data supporting more researches to profoundly explore the psychosocial impact of HIV/AIDS on children and appropriately indicate the need for interventions.
Similar content being viewed by others
References
Alubo, O., Zwandor, A., Jolayemi, T., & Omudu, E. (2002). Acceptance and stigmatization of PLWA in Nigeria. AIDS Care, 14, 117–126.
Ankrah, E. M. (1993). The impact of HIV/AIDS on the family and other significant relationships: The African clan revisited. AIDS Care, 5, 5–22.
Atwine, B., Cantor-Graae, E., & Bajunirwe, F. (2005). Psychological distress among AIDS orphans in rural Uganda. Social Science & Medicine, 3, 555–564.
Children’s Behaviour Problems Research Group (1993). Children’s behavioural problems and their influencing factors: A collaborating survey of 24013 subjects in 22 cities in China. Chinese Mental Health Journal, 7, 13–15.
Dye, J. F., Schatz, I. M., Rosenberg, B. A., & Coleman, S. T. (2000). Constant comparison method: A kaleidoscope of data. Practicing Qualitative Research. Available online: http://www.nova.edu/ssss/QR/QR3-4/dye.html. Accessed 10 March 2006.
Forehand, R., Steele, R., Armistead, L. P., Morse, E., Simon, P., & Clark, L. (1998). The Family Health Project: Psychosocial adjustment of children whose mothers are HIV-infected. Journal of Consulting and Clinical Psychology, 66, 513–520.
Foster, G. (2002). Beyond education and food: Psychosocial well-being of orphans in Africa. Acta Paediatrica, 91, 502–504.
Foster, G., Makufa, C., Drew, R., Mashumba, S., & Kambeu, S. (1997). Perceptions of children and community members concerning circumstances of orphans in rural Zimbabwe. AIDS Care, 9, 391–405.
Harris, E. S. (1991). Adolescent bereavement following the death of a parent: An exploratory study. Child Psychiatry and Human Development, 21, 267–281.
International HIV/AIDS Alliance (2003). Building blocks: Africa-wide briefing notes. Available online: http://synkronweb.aidsalliance.org/graphics/secretariat/publications/bbe30103_bb_psychosocial_support_eng.pdf. Accessed 12 January 2006.
Lee, R. P. L., Ruan, D., & Lai, G. (2005). Social structure and support networks in Beijing and Hong Kong. Social Networks, 27, 249–274.
Li, L., Sun, S., Wu, Z., Wu, S., Lin, C., & Yan, Z. (2007). Disclosure of HIV status is a family matter: Field notes from China. Journal of Family Psychology, 21, 307–314.
Makame, V., Ani, C., & Grantham-Mcgregor, S. (2002). Psychological well being of orphans in Dar El Salaam, Tanzania. Acta Paediatrica, 91, 459–465.
Marshall, M. N. (1996). Sampling for qualitative research. Family Practice, 13, 522–525.
Molzahn, A. E., & Kikuchi, J. F. (1998). Children and adolescents of parents undergoing dialysis therapy: Their reported quality of life. ANNA Journal, 25, 411–417.
Moneyham, L., Seals, B., Demi, A., Sowell, R., Cohen, L., & Guillory, J. (1996). Experiences of disclosure in women infected with HIV. Health Care Women International, 17, 209–221.
Murphy, D. A., Roberts, K. J., & Hoffman, D. (2002). Stigma and ostracism associated with HIV/AIDS: Children carrying the secret of their mothers’ HIV-positive serostatus. Journal of Child and Family Studies, 11, 191–202.
Ntozi, J. P. (1997). Effect of AIDS on children: The problem of orphans in Uganda. Health Transitions Review, 7, S23–S40.
Nyambedha, E. O., Wandibba, S., & Aagaard-Hansen, J. (2003). Changing patterns of orphan care due to the HIV epidemic in western Kenya. Social Science & Medicine, 57, 301–311.
Ostrom, R. A., Serovich, J. M., Lim, J. Y., & Mason, T. L. (2006). The role of stigma in reasons for HIV disclosure and non-disclosure to children. AIDS Care, 18, 60–65.
Raveis, V. H., Siegel, K., & Karus, D. (1999). Children’s psychological distress following the death of a parent. Journal of Youth and Adolescence, 28, 165–180.
Safman, R. M. (2004). Assessing the impact of orphanhood on Thai children affected by AIDS and their caregivers. AIDS Care, 16, 11–19.
Sameroff, A. J., & Mackenzie, M. J. (2003). Research strategies for capturing transactional models of development: The limits of the possible. Development & Psychopathology, 15, 613–640.
Sandler, I. N., Ayers, T. S., Wolchik, S. A., Tein, J.Y., Kwok, O.M., & Haine, R. A. (2003). The family bereavement program: Efficacy evaluation of a theory-based prevention program for parentally-bereaved children and adolescents. Journal of Consulting and Clinical Psychology, 71, 587–600.
Sengendo, J., & Nambi, J. (1997). The psychological effect of orphanhood: A study of orphans in Rakai district. Health Transit Review, 7(Suppl.), 105–124.
Siegel, K., & Gorey, K. (1994). Childhood bereavement due to parental death from acquired immunodeficiency syndrome. Developmental and Behavioral Pediatrics, 15, S66–S70.
Sroufe, L. A., & Rutter, M. (1984). The domain of developmental psychopathology. Child Development, 55, 17–29.
UNAIDS & UNICEF. (2004). Children on the brink 2004. A joint report of new orphan estimates and a framework for action. Available online: http://www.unicef.org/publications/files/cob_layout6-013.pdf. Accessed 19 March 2006.
UNICEF. (2007). Enhanced protection fro children affected by AIDS. Available online: http://www.unicef.org/publications/files/Enhanced_Protection_for_Children_Affected_by_AIDS.pdf. Accessed 19 March 2006.
Wolchik, S. A., Tein, J. Y., Sandler, I. N., & Ayers, T. S. (2006). Stressors, quality of the child-caregiver relationship, and children’s mental health problems after parental death: The mediating role of self-system beliefs. Journal of Abnormal Child Psychology, 34, 221–238.
Woodring, L. A., Cancelli, A. A., Ponterotto, J. G., & Keitel, M. A. (2005). A qualitative investigation of adolescents’ experiences with parental HIV/AIDS. America Journal of Orthopsychiatry, 75, 658–675.
Worden, J. W. (1996). Children and grief: When a parent dies. New York: Guilford Press.
Wu, Z., Zhang, J., Detels, R., Li, V. C., Cheng, H., Duan, S., Li, Z., Dong, L., Huang, S., Jia, M., & Bi, X. (1997). Characteristics of risk-taking behaviors, HIV and AIDS knowledge, and risk perception among young males in southwest China. AIDS Education and Prevention, 9, 147–160.
Xu, W., Ji, C., He, J., Li, H., Zhang, K., & Wang, T. (2004). Preliminary analysis of conditions of AIDS related orphans in selected areas in China. Chinese Journal of AIDS/STD Prevention and Control, 10, 416–419.
Yang, H., Wu, Z., Duan, S., Li, Z., Li, X., Shen, M., Mathur, A., & Stanton, B. (2006). Living environment and school of children with HIV infected parents in Southeast China. AIDS Care. AIDS Care, 18, 647–655.
Yunnan Center for Disease Prevention and Control (2004). HIV/AIDS epidemic and response of Yunnan. Available online: http://www.npfpc.gov.cn/aids/%D5%C5%B3%A4%B0%B2%D6%F7%C8%CE.pdf. Accessed March 19 2006.
Zhang, L. (2006). On the traditions, realities and measures to cope with problems in China's family education. Journal of the Chinese Society of Education, 6, 36–39.
Zhang, Y., Ye, W., Ding, Z., Lu, L., Wang, Z., & Zheng, J. (2002). Comparison of behavioural problems of children in town and countryside in east China. Chinese Mental Health Journal, 16, 736–738.
Acknowledgements
This study was funded by NIH grant number 1U2R TW006918-01, China Multidisciplinary AIDS Prevention Training Program (China ICOHRTA, with Principal Investigator Zunyou Wu). We are grateful to all the children and their caregivers who so willingly participated in this study, as well as our collaborators in local Longchuan County CDC.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Xu, T., Yan, Z., Duan, S. et al. Psychosocial Well-being of Children in HIV/AIDS-Affected Families in Southwest China: A Qualitative Study. J Child Fam Stud 18, 21–30 (2009). https://doi.org/10.1007/s10826-008-9202-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-008-9202-5