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a prospective national study Lucie Cluver , Lorraine Sherr , Mark Orkin , Mark Boyes

Suicide and AIDS-affected children in South Africa. a prospective national study Lucie Cluver , Lorraine Sherr , Mark Orkin , Mark Boyes. National longitudinal study: 6850 children, 2500 adult caregivers, 2008-2012. Longitudinal national survey Main study: N=6000 (age : 10-18)

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a prospective national study Lucie Cluver , Lorraine Sherr , Mark Orkin , Mark Boyes

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  1. Suicide and AIDS-affected children in South Africa a prospective national study LucieCluver, Lorraine Sherr, Mark Orkin, Mark Boyes

  2. National longitudinal study: 6850 children, 2500 adult caregivers, 2008-2012 Longitudinal national survey • Main study: N=6000 (age: 10-18) • 3 provinces South Africa; 6 sites >30% prevalence; 5 languages • Stratified random sampling of census EAs • Every household with a child aged 10-17 • Urban/rural, 1 year follow-up in 2 provinces (n=3401, 97% follow-up) • Measures • Standardised scales: (suicidality: MINI International • Psychiatric Interview for children & adolescents) • Analyses: Principal components analysis, MV hierarchical • logistic regression, multiple mediation in PROCESS • Ethics • Approved by University of Cape Town, Oxford, • KwaZulu-Natal, Province Health & Education Depts • Social & health service referrals.for prior HIV risk

  3. Family AIDS increases childhood adversities AIDS-orphan Stigma .13 Education risks .12 .43 .18 Psych. distress Abuse .32 .14 .72 .08 .15 .15 HIV Risk Behaviour .15 .10 .24 .48 Poverty AIDS-sick parent .22 .21 Violence .14 Cluver, Orkin, Boyes, Sherr, Nikelo, Makhasi (2013). Soc. Sci & Medicine. Analyses funded by RIATT.

  4. AIDS-related adversities and child suicide attempts: mediated by mental health distress Mental health: clinical levels of depression, anxiety, post-traumatic stress Note:All regression weights are unstandardised. Analysis controls for child age and gender, suicide behaviour at baseline, poverty, living in informal vs. formal housing, urban vs. rural location, and province (all measured at baseline).

  5. Family AIDS increases abuse, hunger & violence For already-exposed children, mental health care may reduce suicide risks Together, these raise suicide attempts from 2% - 6% (cumulative OR 2.46 CI 1.00–6.05). We need to mitigate adversities for AIDS-affected families

  6. Funders: thank you. www.youngcarers.org.za Regional Interagency Task Team for Children Affected by AIDS – Eastern & Southern Africa The Economic & Social Research Council National Department of Social Development HEARD, University of KwaZulu-Natal The Nuffield Foundation The Claude Leon Foundation The John Fell Fund The National Research Foundation

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