? AIDS worldwide has orphaned more than 15 million children under the age of 18. By 2010 an estimated 25 million children will be orphaned due to AIDS or 6% of all children in Sub-Saharan Africa. The South and Southeast Asian region has the second largest numbers of persons living with HIV/AIDS. India alone has and estimated 5.1 million adults living with HIV/AIDS. The need to understand factors influencing positive outcomes for orphans across and within cultures is pressing. To date, studies concerning the effects of the placement of orphans have been limited to: comparisons of orphanage versus community placement; small sample sizes; cross-cultural data; and single country studies. Such studies limit the ability to make causal inferences, overly simplify the importance of life events and current living characteristics, and do not account for cultural effects mediating placement outcomes, thereby limiting generalizability to other cultures. The focus of this 4-year longitudinal study is to examine the influence of life events, orphan placement characteristics, caregiver characteristics, and cultural characteristics on orphan: 1) behavioral and emotional adjustment; 2) cognitive adjustment; and 3) health status. 2,500 children and their caregivers will be surveyed and a contextual analysis performed in countries where the HIV epidemic has left some of the largest rates of children orphaned: Cambodia, Ethiopia, India, Kenya, and Tanzania, where a pilot study has been conducted by the researchers. The countries were chosen for their cultural diversity and because they have high proportions of children orphaned by AIDS. Children, ages 6-10 inclusive at baseline, who live in communities and institutions will be surveyed every 6 months for 3 years. Caregiver and institutional characteristics will be surveyed every year for 3 years. Central to the study is an anthropological qualitative component that will both help form questions in the first year of the grant and will later form the context from which we will analyze the data. The later will include detailed open-ended surveys with 20 children and 5 adult focus groups from each country, using grounded theory during the first year, followed by more structured surveys in the following: a minimum of 7 peer-reviewed manuscripts, 1 book, and a major policy document will result from this study. These documents will advise policy makers, programmers, and researchers on the caregiving and cultural characteristics that need consideration when planning for the care of orphaned children. ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD046345-01A2
Application #
6948040
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Haverkos, Lynne
Project Start
2005-08-01
Project End
2010-05-31
Budget Start
2005-08-01
Budget End
2006-05-31
Support Year
1
Fiscal Year
2005
Total Cost
$530,345
Indirect Cost
Name
Duke University
Department
Administration
Type
Schools of Arts and Sciences
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Sinha, Aakanksha; Lombe, Margaret; Saltzman, Leia Y et al. (2016) Exploring Factors Associated with Educational Outcomes for Orphan and Abandoned Children in India. Glob Soc Welf 3:23-32
Gray, Christine L; Whetten, Kathryn; Messer, Lynne C et al. (2016) Potentially traumatic experiences and sexual health among orphaned and separated adolescents in five low- and middle-income countries. AIDS Care 28:857-65
Gray, Christine L; Pence, Brian W; Messer, Lynne C et al. (2016) Civic engagement among orphans and non-orphans in five low- and middle-income countries. Global Health 12:61
Gray, Christine L; Pence, Brian W; Ostermann, Jan et al. (2015) Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study. Glob Health Sci Pract 3:395-404
Gray, C L; Pence, B W; Ostermann, J et al. (2015) Gender (in) differences in prevalence and incidence of traumatic experiences among orphaned and separated children living in five low- and middle-income countries. Glob Ment Health (Camb) 2:
Escueta, Maya; Whetten, Kathryn; Ostermann, Jan et al. (2014) Adverse childhood experiences, psychosocial well-being and cognitive development among orphans and abandoned children in five low income countries. BMC Int Health Hum Rights 14:6
Whetten, Kathryn; Ostermann, Jan; Pence, Brian W et al. (2014) Three-year change in the wellbeing of orphaned and separated children in institutional and family-based care settings in five low- and middle-income countries. PLoS One 9:e104872
Guru Rajan, Divya; Shirey, Kristen; Ostermann, Jan et al. (2014) Child and Caregiver Concordance of Potentially Traumatic Events Experienced by Orphaned and Abandoned Children. Vulnerable Child Youth Stud 9:220-233
O'Donnell, Karen; Murphy, Robert; Ostermann, Jan et al. (2012) A brief assessment of learning for orphaned and abandoned children in low and middle income countries. AIDS Behav 16:480-90
Thielman, Nathan; Ostermann, Jan; Whetten, Kathryn et al. (2012) Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health. PLoS One 7:e38109

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