HIV Incidence and Death Among Orphaned and Nonorphaned Children and Adolescents Living in Family-Based Settings in Western Kenya: A Prospective Cohort Analysis - 05/07/23
, Allison DeLong, MSc 2, Edwin Sang, MSc 3, David Ayuku, PhD 4, Lukoye Atwoli, MBChB, PhD 4, 5, Omar Galárraga, PhD 6, Joseph Hogan, PhD 2, Paula Braitstein, PhD 1, 3, 7, ∗Abstract |
Objective |
To compare the incidence of HIV, death, and abuse among orphaned children to nonorphaned children living in households caring for orphaned children in Western Kenya.
Study design |
A random sample was taken of 300 households caring for at least one orphaned child in Uasin Gishu County, Kenya. All orphaned and nonorphaned children in each selected household were enrolled in a prospective cohort study between 2010 and 2013. A total of 1488 children (487 double orphans, 743 single orphans, and 258 nonorphans) were followed up annually until 2019. Survival analysis was used to estimate hazard ratios and 95% confidence intervals (CIs) of the association between the number of parents the child had lost (none, 1, or 2), and HIV incidence, death, combined HIV incidence or death, and incident abuse.
Results |
Among 1488 children enrolled, 52% of participants were females, 23 were HIV positive, and the median age was 10.4 years. Over the course of the study, 16 orphaned children died and 11 acquired HIV. No deaths or incident HIV infections were observed among the nonorphaned children. Among children who were HIV negative at enrollment, loss of a parent was strongly associated with incident HIV (adjusted hazard ratio: 2.21 per parent lost, 95% CI: 1.03-4.73) and HIV or death (adjusted hazard ratio: 2.46 per parent lost, 95% CI: 1.37-4.42). There were no significant associations between orphan level and abuse.
Conclusions |
In similar households, orphaned children experience a higher risk of HIV and death than nonorphaned children. Both orphaned children and the families caring for them need additional support to prevent adverse health outcomes.
Le texte complet de cet article est disponible en PDF.Keywords : sub-Saharan Africa, HIV/AIDS, mortality, orphans, family-based care, abuse, human rights
Abbreviations list : HR, aHR, AIDS, CI, COVID-19, CT, HIV, OSCAR, IQR, UNICEF
Plan
| This project was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development [R01HD060478]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. |
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| The authors declare no conflicts of interest. |
Vol 258
Article 113410- juillet 2023 Retour au numéro
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