The psychological well-being of children orphaned by AIDS in Cape Town, South Africa

This study aimed to investigate mental health outcomes for urban children living in deprived settlements in Cape Town. 30 orphaned children and 30 matched controls were compared using standardised questionnaires (SDQ) on emotional and behavioural problems, peer and attention difficulties, and prosocial behaviour. The orphan group completed a modified version of a standardised questionnaire (IES-8), measuring Post-Traumatic Stress symptoms. Group differences were tested using t-tests and Pearson's chi-square.Both groups scored highly for peer problems, emotional problems and total scores. However, orphans were more likely to view themselves as having no good friends (p = .002), to have marked concentration difficulties (p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display anger through loss of temper (p = .03). Orphans were more likely to have constant nightmares (p = .01), and 73% scored above the cut-off for Post-Traumatic Stress Disorder.Findings suggest important areas for larger-scale research for parentally-bereaved children.An estimated 24.8% of South Africa's population are HIV+, with 4.7 million infected by 2001 [1]. Numbers of children parentally bereaved by AIDS in South Africa are expected to rise from 1.1 million in 2003, to 3.1 million by 2010 [2], peaking at 5.7 million in 2015. Even with the proposed full administration of anti-retroviral therapy, estimates remain at 1.15 million maternal orphans by 2015 [3].Orphaned children in South Africa have traditionally been cared for within the extended family [4], often by elderly grandparents [5]. There are concerns that this support system is weakening as orphan numbers and HIV prevalence increase [6]. There are few reliable data on numbers of orphans living in non-kin fostering arrangements, institutions, child-headed households and as streetchildren [7].Most work on orphans concentrates on basic needs. This is understandable as AIDS-affected households are character