The mental health of children orphaned by AIDS: a review of international and southern African research

This paper reviews research on the mental health and psychological outcomes of children who are orphaned by AIDS. Studies are limited, scattered and often unpublished. The review focuses on research which is quantitative and based on primary research with uninfected children who are parentally bereaved by AIDS. Due to the limited available quantitative research in this area, both controlled and uncontrolled studies are included. Selected qualitative and related literature is also reviewed, with a focus on work relevant to the southern African context. This paper builds upon and updates Wild's seminal review, published in this journal in 2001 (Wild 2001). We found 24 studies worldwide, with wide variations in sample characteristics, outcome measurements and control groups. Three of these studies are ongoing. Internalising problems in orphaned children were found in 16 studies (of the 19 studies which measured them) and externalising problems were found in five studies (of 10 which measured them). There is a clear need for further, and rigorous, research into mental health, and risk and protective factors for children orphaned by AIDS. Furthermore, it is critical that research adopts a more coordinated approach, which allows for meaningful comparisons of child outcomes in different areas.