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Covid-19 infections and related illness and death are rightly at the forefront of our minds. It is critical that we consider how to reduce infections, treat those who are ill and protect health sys...

This research explored the biological and social support relationship between youth orphaned due to AIDS and his/her caregiver to identify protective factors that are related to positive mental health outcomes. These youth have significantly higher levels of depression, anxiety, and post-traumatic stress (PTS) symptoms compared to those orphaned due to other causes and non-orphans. Using a 2009 cross-sectional data-set from South Africa, 254 youth orphaned due to AIDS were purposively selected from the overall sample of 732 to further examine this caregiver relationship. Caregiver relation was analyzed in several combinations to determine if it was significantly related to mental health outcomes, with only anxiety showing significance. Those living with a biological parent had significantly higher anxiety symptoms than those living with a grandparent, other kin, or non-kin. Anxiety was also significantly related to an increased age, lower levels of emotional support, and lower levels of instrumental/financial support (R2 = .153). Age was the only significant variable from the model that was related to depression symptoms (R2 = .111). PTS symptoms were related to increases in age, lower levels of emotional support, instrumental/financial support, and satisfaction with the caregiver (R2 = .194). Gender and age were related to suicidal tendencies, specifically boys were 2.26 times more likely to exhibit suicidal tendencies compared to girls, and every yearly increase in age results in the youth being 1.22 times more likely to exhibit suicidal tendencies. Strengthening the caregiver’s ability to provide social support for the child is critical, irrespective of any biological kin relationship.

‘Young carers’ are children who take on adult responsibility in response to familial illness. South Africa’s high disease burden, limited health care capacity and cultural notions of children’s familial duty suggest a large population of ‘young carers’ in this country. This study aims to explore the nature of responsibility among children affected by illness in deprived South African communities. A total of 349 children and adolescents aged 10–18 years in illness-affected households in the Western Cape province were recruited via community- and school-based convenience sampling. Data about their daily life, responsibilities and the impact of familial illness were collected via semi-structured interviews. Caring tasks involving intimate contact and medical treatments were relatively common among children in the sample, and nearly all children were engaged in some type of responsibility, from caring tasks to housework, childcare and earning money. Children frequently indicated their responsibilities constituted a substantial burden. Responses suggested a tension between duty to care and appropriateness of intimate contact between parents and children required for some caring responsibilities. Children often linked their tasks burden to familial illness, though further quantitative research is needed to identify the drivers of child responsibility.

Considerable attention has been provided to the potential adverse outcomes for youth in the context of HIV and AIDS. Using data from a large community-based study on the psychosocial well-being of youth affected by HIV and AIDS, this paper advances a strength-based, resiliency perspective that is centred on the construct of prosociality. Data was derived from the Young Carers South Africa Project, where a cross-sectional household survey was conducted with 2,477 child-carer pairs in an HIV endemic community in the province of KwaZulu-Natal, South Africa. Analysis in this paper focuses on a subset of 2,136 child-carer pairs. Perceptions of child prosociality were assessed using the Prosocial Scale of the Strengths and Difficulties Questionnaire (SDQ). Both child and carer responses were obtained to provide insight into the functioning of carer-child dyads. Descriptive and inferential analysis was conducted to explore ratings of child prosociality across different relational contexts affected by HIV and involving care for orphaned youths. Dual-affected households, where carers are ill with opportunistic infections and youth are orphaned due to AIDS, yielded the highest discrepancies with carers reporting low child prosociality and children self-reporting high prosociality. Carer ill health appears to play a role in differentiating child prosociality across relational contexts involving non-orphaned youth. Further research is needed to explore child prosociality as a protective mechanism in high HIV-endemic communities.