Are adolescent orphans more likely to be HIV-positive? A pooled data analyses across 19 countries in sub-Saharan Africa. Issue 8 (10th February 2016)

• Record Type: Journal Article
• Authors: Kidman, Rachel; Anglewicz, Philip
• Is Part Of: Journal of epidemiology and community health. Volume 70:Issue 8(2016)
• Page Start: 791
• Page End: 797
• Publication Date: 2016-02-10
• Subjects: HIV -- INTERNATIONAL HLTH -- MULTILEVEL MODELLING -- SOCIAL FACTORS IN -- CHILD HEALTH; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2015-206744
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Despite extensive resources and numerous programmes directed towards orphans in sub-Saharan Africa, evidence of their disadvantage is surprisingly limited. While initial research suggests that orphans are at greater risk of being HIV-positive, the evidence is limited in geographic scope. Methods: To rigorously test disparities in HIV prevalence related to orphanhood and parental HIV status in sub-Saharan Africa, we used Demographic and Health Survey data from 19 countries in sub-Saharan Africa. We conducted pooled multilevel logistic regression on adolescents aged 15–17 years with HIV test results (N=22 837 girls and 20 452 boys). Results: Regardless of their gender, orphans who lost their mother, lost both parents or had an HIV-infected mother were two to three times more likely to test positive for HIV infection (ORs 1.87–3.17). The loss of a father was also associated with HIV infection risk for females, but of slightly lower magnitude (OR 1.63). Conclusions: To better inform interventions, future research is needed to quantify the relative contribution of perinatally-acquired and sexually-acquired infections, and to investigate the specific mechanisms that may account for disparities in the latter. In the meantime, programmes serving HIV-infect adults as well as those serving orphaned and vulnerable children should invest in family-based HIV testing in order to identify adolescents in need of treatment.