Psychosocial challenges and protective influences for socio-emotional coping of HIV+ adolescents in South Africa: a qualitative investigation
- 12 March 2010
- journal article
- aidsimpact special-issue-2010
- Published by Informa UK Limited in AIDS Care
- Vol. 22 (8), 970-978
- https://doi.org/10.1080/09540121003623693
Abstract
Introduction. While the roll-out of antiretroviral therapy in South Africa should lead to a reduction in mother to child transmission, mortality and orphaning, it will also be accompanied by a large number of children entering adolescence and adulthood with a chronic infectious disease. Adolescence is a particularly vulnerable period for HIV-infected people in relation to mental health problems and engagement in high-risk behaviours, including non-compliance with medical treatment. The goal of this qualitative study was to develop an understanding of the psychosocial challenges as well as protective influences promoting socio-emotional coping in HIV+ adolescents in order to inform mental health promotion and HIV prevention programming for this population in South Africa. Method. In-depth qualitative interviews were conducted with HIV+ adolescents (25) and caregivers of HIV+ children (15) at a large HIV/AIDS Clinic in South Africa. Data were analysed thematically using NVivo8 software. Results. Psycho-social challenges for adolescents included dealing with loss of biological parents in the case of orphans; coming to terms with their HIV+ status including identity difficulties; external stigma and discrimination; and disclosure difficulties. For caregivers, disclosure and lack of financial, family and social support emerged as key challenges. Medication, HIV information, a future orientation and social support was identified as important for coping and general well-being of adolescents, with financial and social support emerging as key for promoting supportive caregiving contexts. Conclusion. While HIV+ adolescents in South Africa experience similar concerns to those in high-income countries, socio-emotional coping may be compromised by increased levels of loss due to the late roll-out of ARVS and challenges to caregiving contexts including poverty, stigma and minimally supported foster care arrangements. There is a need for mental health promotion programmes for adolescents to adopt an ecological approach, strengthening protective influences at the individual, interpersonal, community and policy levels.Keywords
This publication has 28 references indexed in Scilit:
- AIDS among older children and adolescents in Southern Africa: projecting the time course and magnitude of the epidemicAIDS, 2009
- Facilitating health-enabling social contexts for youth: qualitative evaluation of a family-based HIV-prevention pilot programmeAfrican Journal of AIDS Research, 2009
- Effects of Stigma on the Mental Health of Adolescents Orphaned by AIDSJournal of Adolescent Health, 2008
- Promoting child and adolescent mental health in the context of the HIV/AIDS pandemic with a focus on sub‐Saharan AfricaJournal of Child Psychology and Psychiatry, 2008
- Psychological distress amongst AIDS‐orphaned children in urban South AfricaJournal of Child Psychology and Psychiatry, 2007
- Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their FamiliesSocial Work in Mental Health, 2007
- Disclosure of an HIV Diagnosis to Children: History, Current Research, and Future DirectionsJournal of Developmental & Behavioral Pediatrics, 2007
- Preliminary outcomes of a paediatric highly active antiretroviral therapy cohort from KwaZulu-Natal, South AfricaBMC Pediatrics, 2007
- Mediating Social Representations Using a Cartoon Narrative in the Context of HIV/AIDS The AmaQhawe Family Project in South AfricaJournal of Health Psychology, 2006
- The Psychosocial Issues of Children with Perinatally Acquired HIV Disease Becoming Adolescents: A Growing Challenge for ProvidersAIDS Patient Care and STDs, 2001