Skip to main content

Advertisement

SpringerLink
Log in

Impact of care at foster homes on the health-related quality of life of HIV-infected children and adolescents: a cross-sectional study from India

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To assess the impact of care at foster homes on the health-related quality of life (HRQOL) of children living with HIV (CLHIV), attending a referral ART Centre, and to compare their HRQOL with children living in their own homes.

Methods

A cross-sectional study was conducted in 144 CLHIV between 5 and 18 years of age, attending a referral ART Centre in South India to assess their HRQOL using the standard PedsQL™ 4.0 questionnaire. Data were then analysed to compare the HRQOL of children living in foster homes to those children living in their own homes. The child report and the parent proxy-report on the child’s HRQOL were also compared to see for any differences in their perspectives.

Results

56.25% CLHIV were brought up in different foster homes. In the child’s self-report, the mean HRQOL was higher for children living in foster homes [physical score (76.54 ± 12.40), psychosocial score (71.41 ± 12.40) and total score (73.20 ± 11.13)] when compared to children living in their own homes [physical score (75.09 ± 14.76), psychosocial score (70.60 ± 13.48) and total score (72.17 ± 12.00)]. There was no statistically significant difference in the HRQOL between these two groups (p > 0.05). In the parent proxy-report also, there was no statistically significant difference in the HRQOL in all the three scores. The child self-report depicted a significantly higher HRQOL in all the domains compared to the parent proxy-report (p < 0.05).

Conclusions

HRQOL of children living in foster homes is at par with the quality of life enjoyed by children living in their own homes. Foster care manages to provide a reasonable HRQOL in CLHIV, and has become an inseparable component of quality health care delivery for these children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gallo, R. C., & Montagnier, L. (2003). Cluster of Kaposi’s Sarcoma and Pneumocystis carinii pneumonia among homosexual male residents of Los Angeles and range Counties, California. The New England Journal of Medicine, 349(24), 2283–2285.

    Article  CAS  PubMed  Google Scholar 

  2. Ledlie, S. W. (2001). The psychosocial issues of children with perinatal acquired HIV disease becoming adolescents: A growing challenge for providers. AIDS Patient Care and STDs, 15, 231–236.

    Article  CAS  PubMed  Google Scholar 

  3. Berk, D. R., Falkovitz-Halpern, M. S., David, W.. Hill, Catherine, Albin, Antonio, Arrieta, Jane M., Bork, Deborah, Cohan, et al. (2005). Temporal trends in early clinical manifestations of perinatal HIV infection in a population-based cohort. JAMA: The Journal of the American Medical Association, 293(18), 2221–2231.

    Article  CAS  PubMed  Google Scholar 

  4. Patel, K., Hernan, M. A., Williams, P. L., Seeger, J. D., McIntosh, K., Van Dyke, R. B., & Seage, G. R., et al. (2008). Long-term effectiveness of highly active antiretroviral therapy on the survival of children and adolescents with HIV infection: A 10-year follow-up study. Clinical Infectious Diseases: An Official Publication of The Infectious Diseases Society of America, 46(4), 507–515.

    Article  Google Scholar 

  5. de Martino, M., Tovo, P. A., Balducci, M., Pier-Angelo Tovo, Maria, Balducci, Luisa, Galli, et al. (2000). Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection: Italian Register for HIV Infection in Children and the Italian National AIDS Registry. JAMA: The Journal of The American Medical Association, 284(2), 190–197.

    Article  PubMed  Google Scholar 

  6. Janssens, B., Raleigh, B., Soeung, S., Seithaboth Soeung, Kazumi, Akao, Vantha, Te, Jitendra, Gupta, et al. (2007). Effectiveness of highly active antiretroviral therapy in HIV-positive children: Evaluation at 12 months in a routine program in Cambodia. Pediatrics, 120(5), e1134–e1140.

    Article  PubMed  Google Scholar 

  7. Puthanakit, T., Aurpibul, L., Oberdorfer, P., Akarathum, N., Kanjanavanit, S., Wannarit, P., et al. (2007). Sustained immunologic and virologic efficacy after four years of highly active antiretroviral therapy in human immunodeficiency virus infected children in Thailand. The Pediatric Infectious Disease Journal, 26, 953.

    Article  PubMed  Google Scholar 

  8. Bunupuradah, T., Puthanakit, T., Kosalaraksa, P., Kosalaraksa, P., Kerr, S., Boonrak, P., Prasitsuebsai, W., Lumbiganon, P., et al. (2011). Immunologic and virologic failure after first-line NNRTI-based antiretroviral therapy in Thai HIV-infected children. AIDS Research Therapy, 8(1), 1.

    Article  Google Scholar 

  9. Pediatric Antiretroviral Therapy (ART) Guidelines. National AIDS Control Organisation. http://naco.gov.in/sites/default/files/Pediatric_14-03-2014.pdf. Accessed March 2, 2017.

  10. Joint United Nations Programme on HIV/AIDS. (2010). Global report: UNAIDS report on the global AIDS epidemic 2010. http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf. Accessed January 12, 2017.

  11. Ministry of Health & Family Welfare, Government of India. Annual Report 2015-16. http://naco.gov.in/sites/default/files/Annual%20Report%202015-16.pdf. Accessed March 2, 2017.

  12. Remien, R. H., & Mellins, C. A. (2007). Long-term psychosocial challenges for people living with HIV: Let’s not forget the individual in our global response to the pandemic. AIDS (London, England), 21(Suppl 5), S55–S63.

    Article  Google Scholar 

  13. Justice, A. C., Holmes, W., Gifford, A. L., Rabeneck, L., Zackin, R., Sinclair, G., et al. (2001). Development and validation of a self-completed HIV symptom index. Journal of Clinical Epidemiology, 54(Suppl 1), S77–S90.

    Article  PubMed  Google Scholar 

  14. Li, X., Naar-King, S., Barnett, D., Stanton, B., Fang, X., & Thurston, C. (2008). A developmental psychopathology framework of the psychosocial needs of children orphaned by HIV. The Journal of The Association of Nurses in AIDS Care, 19(2), 147–157.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Xu, T., Wu, Z., Rou, K., Duan, S., & Wang, H. (2010). Quality of life of children living in HIV/AIDS-affected families in rural areas in Yunnan, China. AIDS Care, 22(3): 390–396.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lee, G. M., Gortmaker, S. L., McIntosh, K., Hughes, M. D., & Oleske, J. M. (2006). Quality of life for children and adolescents: Impact of HIV infection and antiretroviral treatment. Pediatrics, 117(2), 273–283.

    Article  PubMed  Google Scholar 

  17. Vranda, M. N., & Mothi, S. N. (2013). Psychosocial issues of children infected with HIV/AIDS. Indian Journal of Psychological Medicine, 35(1), 19–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Perrin, J. M., & Maclean, W. J. (1988). Children with chronic illness: The prevention of dysfunction. Pediatric Clinics of North America, 35, 1325–1337.

    Article  CAS  PubMed  Google Scholar 

  19. Wallander, J. L., Varni, J. W., Babani, L., Banis, H. T., & Wilcox, K. T. (1988). Children with chronic physical disorders: Maternal reports of their psychological adjustment. Journal of Pediatric Psychology, 13(2), 197–212.

    Article  CAS  PubMed  Google Scholar 

  20. NACO. Annual Report 2013–2014. New Delhi: Department of AIDS Control, MOHFW.

  21. Das, S., Mukherjee, A., Lodha, R., & Vatsa, M. (2010). Quality of life and psychosocial functioning of HIV infected children. Indian Journal of Pediatrics, 77, 633–637.

    Article  PubMed  Google Scholar 

  22. Gupta, M., Nanda, S., & Kaushik, J. S. (2013). Quality of life in symptomatic HIV infected children. Indian Pediatrics, 50(12), 1145–1147.

    Article  PubMed  Google Scholar 

  23. Pai, M. S., & Nayak, B. S. (2014). Quality of life and Social Support among Children Living with HIV (CLHIV) in South India. IOSR Journal of Nursing and Health Science, 3(6), 55–58.

    Article  Google Scholar 

  24. Khanal, A. B. (2016). Sampling. In Mahajan’s methods in biostatistics for medical students and research workers (8th edn., p. 118). New Delhi: Jaypee Brothers Medical Publishers Ltd.

    Chapter  Google Scholar 

  25. Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL™* 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambulatory Pediatrics, 3(6), 329–341.

    Article  PubMed  Google Scholar 

  26. Varni, J. W., Seid, M., & Rode, C. A. (1999). The PedsQL™: Measurement model for the pediatric quality of life inventory. Medical care, 37(2), 126–139.

    Article  CAS  PubMed  Google Scholar 

  27. Khadilkar, V., & Khadilkar, A. (2011). Growth charts: A diagnostic tool. Indian Journal of Endocrinology and Metabolism, 15(7), 166.

    Article  Google Scholar 

  28. Atwine, B., Cantor-Graae, E., & Bajunirwe, F. (2005). Psychological distress among AIDS orphans in rural Uganda. Social Science & Medicine, 61(3), 555–564.

    Article  Google Scholar 

  29. Hunter, S. S. (1990). Orphans as a window on the AIDS epidemic in sub-Saharan Africa: Initial results and implications of a study in Uganda. Social Science & Medicine, 31(6), 681–690.

    Article  CAS  Google Scholar 

  30. Foster, G., Makufa, C., Drew, R., Mashumba, S., & Kambeu, S. (1997). Perceptions of children and community members concerning the circumstances of orphans in rural Zimbabwe. AIDS Care, 9(4), 391–405.

    Article  CAS  PubMed  Google Scholar 

  31. Cluver, L., & Gardner, F. (2007). Risk and protective factors for psychological well-being of children orphaned by AIDS in Cape Town: A qualitative study of children and caregivers’ perspectives. AIDS Care, 19(3), 318–325.

    Article  CAS  PubMed  Google Scholar 

  32. Acharya, S. L., Pokhrel, B. R., Ayer, R., Belbase, P., Ghimire, M., & Gurung, O. (2013). Kinship care at community is better model to ensure psychosocial and economic security to orphans living with HIV than from care homes. Journal of Nepal Health Research Council, 11(23), 22–25

    CAS  PubMed  Google Scholar 

  33. Giese, S., & Dawes, A. (1999). Child care, developmental delay and institutional practice. South African Journal of Psychology, 29(1), 17–22.

    Article  Google Scholar 

  34. Ahmad, A., Qahar, J., Siddiq, A., Majeed, A., Rasheed, J., Jabar, F., & Von Knorring, A. L. (2005). A 2-year follow-up of orphans’ competence, socioemotional problems and post-traumatic stress symptoms in traditional foster care and orphanages in Iraqi Kurdistan. Child Care, Health and Development, 31(2), 203–215.

    Article  CAS  Google Scholar 

  35. Jelsma, J., Davids, N., & Ferguson, G. (2011). The motor development of orphaned children with and without HIV: Pilot exploration of foster care and residential placement. BMC Pediatrics, 11(1), 1.

    Article  Google Scholar 

  36. Australian Human Rights and Equal Opportunity Commission. (2006). Bringing them home: The effects of Institutionalisation-the report. http://www.austlii.edu.au.

  37. Dobrova-Krol, N. A., Van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Juffer, F. (2010). Effects of perinatal HIV infection and early institutional rearing on physical and cognitive development of children in Ukraine. Child Development, 81(1), 237–251.

    Article  PubMed  Google Scholar 

  38. Mutwa, P. R., Van Nuil, J. I., Asiimwe-Kateera, B., Kestelyn, E., Vyankandondera, J., Pool, R., et al. (2013). Living situation affects adherence to combination antiretroviral therapy in HIV-infected adolescents in Rwanda: A qualitative study. PLoS ONE, 8(4), e60073.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank the Karnataka State AIDS Prevention Society and ART Centre, Mangaluru; Dr Unnikrishnan, Associate Dean, Professor and Head, Department of Community Medicine, Kasturba Medical College, Mangaluru; and Dr M. Ventakatraya Prabhu Dean and Professor of Medicine, Kasturba Medical College, Mangaluru.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Kasturba Medical College, Manipal University, Mangaluru, Karnataka, India

    K. G. Gopakumar, Kamalakshi G. Bhat & Shantharam Baliga

  2. Department of Community Medicine, Kasturba Medical College, Manipal University, Mangaluru, Karnataka, India

    Nitin Joseph

  3. Government Medical College, Kozhikode, Kerala, India

    Neha Mohan

  4. Global Health Education, Wake Forest School of Medicine, Winston-Salem, NC, 27157-1042, USA

    Avinash K. Shetty

Authors
  1. K. G. Gopakumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kamalakshi G. Bhat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shantharam Baliga
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nitin Joseph
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Neha Mohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Avinash K. Shetty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. G. Gopakumar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gopakumar, K.G., Bhat, K.G., Baliga, S. et al. Impact of care at foster homes on the health-related quality of life of HIV-infected children and adolescents: a cross-sectional study from India. Qual Life Res 27, 871–877 (2018). https://doi.org/10.1007/s11136-017-1726-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-017-1726-y

Keywords

Search

Navigation