Pantelic, M., Langhaug, L., Moonga F.,Wespi, K., Ammann, P., and Gschwend, A.

1. Children's poverty and morbidity override AIDS-related orphanhood in predicting stigma and bullying Pantelic, M., Langhaug, L., Moonga F.,Wespi, K., Ammann, P., and Gschwend, A.

2. background UNICEF 2012 • 55,100 orphans in sub-Saharan Africa • 15,000 HIV/AIDS-related orphans

3. Multiple adversities facing orphans

4. REPeRCUSSIONSOF stigmatization and bullying Boyes & Cluver 2013, Boyes et al. 2014, Geel et al. 2014

5. Research rationale • Little known about what factors stigmatize orphans • Existing research identifies AIDS-related orphanhood as a key stigmatizing marker (Boyes & Cluver 2013) • Limited programmatic implications • Other markers? • Interventions should be sensitive to the needs of orphans

6. Research question • How are 3 stigma markers associated with perceived stigma and bullying victimization in Zambian orphans? Poverty Morbidity AIDS-related orphanhood

7. METHOD • Cross-sectional survey (n=957) • Swiss Academy for Development • Total population sampling of orphaned adolescents (n=484) • ChildFund Zambia registers • 5 communities in Kafue District, Zambia • Ethics approval obtained from University of Zambia • Same-sex face-to-face interviews

8. measures • Stigma: brief Stigma-by-Association scale (Boyes et al. 2012) • Bullying victimization: adapted Multidimensional Peer-Victimization Scale (Mynard & Joseph 2000) • Food insecurity: # of days without food in the past week (Makame et al. 2002, Cluver et al. 2009) • Physical health: past month frequency of somatic complaints • AIDS-related orphanhood: verbal autopsy (WHO 2005)

9. Descriptive results (orphan sample) • 15 % lost parent due to HIV/AIDS • 25 % reported hunger for 2+ days in past wk • 56 % reported 3+ somatic complaints in past mo • 72 % reported any perceived stigma • 89 % reported any bullying victimization

10. results

11. RESULTS • Together, poor health and food insecurity accounted for: • 10.3 % (R2 change=.103) of the variation in perceived stigma • 9.1 % (R2 change = .091) of the variation in bullying victimization

12. results Orphan stigma and bullying scores by food insecurity and health

13. SUMMARY & IMPLICATIONS • AIDS-related orphanhood NOTassociated with stigma or bullying victimization in our sample • Extreme poverty and morbidity were associated with stigma and bullying of orphans. • Potential for: • Poverty alleviation and health promotion programs • Whole-school approaches (Vreeman and Carroll 2007)

14. SUMMARY & IMPLICATIONS Encouraging note: We might not be able to change parental cause of death, but we can affect child poverty and health.

15. Thank You

16. Post hoc confirmatory analysis • Do orphan poverty and ill health mediate a link between AIDS-related orphanhood and stigma and bullying? • Univariate regressions to check whether AIDS-related orphanhood predicts stigma and/or bullying independently of orphan poverty and orphan health • Again, no associations between AIDS-related orphanhood and the two outcomes were found • No mediation pathway

17. DETERMINING PARENTAL CAUSE OF DEATH • InterVA software, probabilistic epidemiological model • Standard WHO model