@article{ref1,
title="Exposure to violence and psychological well-being over time in children affected by HIV/AIDS in South Africa and Malawi",
journal="AIDS care",
year="2016",
author="Skeen, S. and Macedo, A. and Tomlinson, M. and Hensels, I. S. and Sherr, L.",
volume="28",
number="Suppl 1",
pages="16-25",
abstract="Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS. Yet, in sub-Saharan Africa, where HIV rates are high, efforts to prevent or address violence against children and its long-lasting effects are hampered by a lack of evidence. We assessed the relationship between violence exposure and mental health among HIV-affected children attending community-based organisations in South Africa (n = 834) and Malawi (n = 155, total sample n = 989) at baseline and 12-15-month follow-up. Exposure to violence in the home and in the community was high. HIV-negative children who lived with an HIV-positive person experienced most violence overall, followed by HIV-positive children. Children unaffected by HIV experienced least violence (all p <.05). Interpersonal violence in the home predicted child depression (β = 0.17, p <.001), trauma symptoms (β = 0.17, p <.001), lower self-esteem (β = -0.17, p <.001), and internalising and externalising behavioural problems (β = 0.07, p <.05), while exposure to community violence predicted trauma symptoms (β = 0.16, p <.001) and behavioural problems (β = 0.07, p <.05). Harsh physical discipline predicted lower self-esteem (β = -0.18, p <.001) and behavioural problems for children (β = 0.24, p <.001). Exposure to home (OR: 1.89, 95% CI: 1.23-2.85) and community violence predicted risk behaviour (OR: 2.39, 95% CI: 1.57-3.62). Over time, there was a decrease in depressed mood and problem behaviours, and an increase in self-esteem for children experiencing different types of violence at baseline. This may have been due to ongoing participation in the community-based programme. These data highlight the burden of violence in these communities and possibilities for programmes to include violence prevention to improve psychosocial well-being in HIV-affected children.<p /> <p>Language: en</p>",
language="en",
issn="0954-0121",
doi="10.1080/09540121.2016.1146219",
url="http://dx.doi.org/10.1080/09540121.2016.1146219"
}