HIV/AIDS and Orphan Care

描述（由申请人提供）：

DESCRIPTION (provided by applicant): 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.