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AIDS-Affected Orphans in Sub-Saharan Africa: A Scoping Review on Outcome Differences in Rural and Urban Environments

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Abstract

Currently, there are more than 11 million AIDS-affected orphans that suffer from various adverse effects, most of whom reside in sub-Saharan Africa. The difference between whether a child resides in a rural or urban environment can have a significant role in a child’s education, health status and access to healthcare, and social or family relationships. A scoping review was conducted in order to understand any possible environment-based differences on orphans directly affected by HIV/AIDS in sub-Saharan Africa. There were 233 sources used for this review; however, 164 manuscripts focused more so on a general review of orphans within a rural or urban environment. Thus, after eliminating for various factors, 69 manuscripts were removed, which focused primarily on the social aspect of orphans due to HIV/AIDS. Rural environments provided more family support, while urban environments generally had more resources available to orphans (e.g. school fees). Unfortunately, both rural and urban environments were found to be fairly non-supportive of orphans and their development. This scoping review found, in general, that orphans in both urban and rural environments continue to suffer from the consequential effects of low parental support due to AIDS mortality. These conclusions suggest that specific support to orphans through school and social relationships encourage better development outcomes in sub-Saharan Africa.

Abstracto

Actualmente, hay más de 11 millones de huérfanos afectados por el SIDA que sufren diversos efectos adversos, la mayoría de ellos residen en el África subsahariana. La diferencia entre si un niño reside en un entorno rural o urbano puede tener un rol importante en la educación, el estado de salud y el acceso a la atención médica, y las relaciones sociales o familiares de un niño. Se realizó una revisión de la literatura para entender las posibles diferencias ambientales en huérfanos directamente afectados por el VIH/SIDA en el África subsahariana. Hubo 233 fuentes utilizadas para esta revisión; sin embargo, 164 manuscritos se centraron más en una revisión general de huérfanos dentro de un entorno rural o urbano. Los entornos rurales proporcionaron más apoyo familiar, mientras que los entornos urbanos generalmente tenían más recursos disponibles para los huérfanos (por ejemplo, pagos escolares). Desafortunadamente, se descubrió que tanto el medio rural como el urbano no apoyaban a los huérfanos y su desarrollo. Esta revisión de la literatura encontró, en general, que los huérfanos en entornos urbanos y rurales continúan sufriendo los efectos secundarios del bajo apoyo de los padres debido a la mortalidad por SIDA. Estas conclusiones sugieren que el apoyo específico a los huérfanos a través de las relaciones escolares y sociales fomenta mejores resultados de desarrollo en el África subsahariana.

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References

  1. Fact Sheet 2016 [Internet]. Geneva: Joint United Nations Programme on HIV/AIDS; 2016 [cited 2016 Jul 10]. http://www.unaids.org/en/resources/fact-sheet.

  2. HIV/AIDS prevalence in sub-Saharan Africa [Internet]. Geneva: World Health Organization; 2016 [cited 2016 Jul 10]. http://www.who.int/gho/urban_health/outcomes/hiv_prevalence.

  3. Prevalence of HIV among adults aged 15 to 49 estimates by country [Internet]. Geneva: World Health Organization; 2016 [cited 2016 Mar 3]. http://apps.who.int/gho/data/node.main.622?lang=en.

  4. National AIDS and STI Control Programme: Kenya AIDS Indicator Survey, KAIS 2007 Final Report. Nairobi, Kenya: Ministry of Health; 2009.

  5. Africa’s orphaned generations. New York: United Nations Children’s Emergency Fund; 2003. New York: UNICEF.

  6. Agricultural & rural development [Internet]. Washington, DC: World Bank; 2016 [cited 2016 Jul 10]. http://data.worldbank.org/topic/agriculture-and-rural-development.

  7. Hove M, Ngwerume ET, Muchemwa C. The Urban crisis in sub-Saharan Africa: a threat to human security and sustainable development. Int J Sec Dev. 2013;2(1):1–14. https://doi.org/10.5334/sta.ap.

    Article  Google Scholar 

  8. The state of the world’s children. New York: United Nations Children’s Emergency Fund; 2012.

  9. Evans GW. Child development and the physical environment. Annu Rev Psychol. 2006;57(1):423–51. https://doi.org/10.1146/annurev.psych.57.102904.190057.

    Article  PubMed  Google Scholar 

  10. Ferguson KT, Cassells RC, Macallister JW, Evans GW. The physical environment and child development: An international review. Int J Psychol. 2013;48(4):437–68. https://doi.org/10.1080/00207594.2013.804190.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bornstein MH, Britto PR, Nonoyama-Tarumi Y, Ota Y, Petrovic O, Putnick DL. Child development in developing countries: introduction and methods. Child Dev. 2012;83(1):16–31. https://doi.org/10.1111/j.1467-8624.2011.01671.x.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gottlieb G, Wahlsten D, Lickliter R. The significance of biology for human development: a developmental psychobiological systems view. Hoboken: Wiley; 2006.

    Google Scholar 

  13. Lerner RM. Developmental science, developmental systems, and contemporary theories of human development. Medford: Wiley; 2006.

    Google Scholar 

  14. Foster G, Williamson J. A review of current literature of the impact of HIV/AIDS on children in sub-Saharan Africa. AIDS. 2000;14:S275–84.

    PubMed  Google Scholar 

  15. Lerner RM, Theokas C, Bobek DL. Concepts and theories of human development: historical and contemporary dimensions. In: Bornstein MH, Lamb ME, editors. Developmental science: an advanced textbook. 5th ed. New York: Psychology Press; 2005. p. 3–43.

    Chapter  Google Scholar 

  16. United Nations Children's Fund. A growing number of countries are developing national action plans for orphans and other vulnerable children (2016). Available online at http://data.unicef.org/hiv-aids/care-support.html.

  17. Cluver L, Orkin M, Boyes M, Gardner F, Meinck F. Transactional sex amongst AIDS-orphaned and AIDS-affected adolescents predicted by abuse and extreme poverty. JAIDS. 2011;58(3):336–43. https://doi.org/10.1097/qai.0b013e31822f0d82.

    Article  PubMed  Google Scholar 

  18. Monasch R, Boerma JT. Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS. 2004;18(Supplement 2):S55–65. https://doi.org/10.1097/00002030-200406002-00007.

    Article  PubMed  Google Scholar 

  19. Atwine B, Cantor-Graae E, Bajunirwe F. Psychological distress among AIDS orphans in rural Uganda. Soc Sci Med. 2005;61(3):555–64. https://doi.org/10.1016/j.socscimed.2004.12.018.

    Article  PubMed  Google Scholar 

  20. Cluver LD, Gardner F, Operario D. Effects of stigma on the mental health of adolescents orphaned by AIDS. J Adolesc Health. 2008;42(4):410–7. https://doi.org/10.1016/j.jadohealth.2007.09.022.

    Article  PubMed  Google Scholar 

  21. Cluver L, Orkin M. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa. Soc Sci Med. 2009;69(8):1186–93. https://doi.org/10.1016/j.socscimed.2009.07.033.

    Article  PubMed  Google Scholar 

  22. Cluver LD, Orkin M, Gardner F, Boyes ME. Persisting mental health problems among AIDS-orphaned children in South Africa. J Child Psychol Psyc. 2012;53(4):363–70. https://doi.org/10.1111/j.1469-7610.2011.02459.x.

    Article  Google Scholar 

  23. Cluver L, Gardner F. The psychological well-being of children orphaned by AIDS in Cape Town, South Africa. Ann Gen Psychiatry. 2006. https://doi.org/10.1186/1744-859x-5-8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Cluver L, Gardner F, Operario D. Psychological distress amongst AIDS-orphaned children in urban South Africa. J Child Psychol Psychiatry. 2007;48(8):755–63.

    Article  Google Scholar 

  25. Makame V, Ani C, Grantham-Mcgregor S. Psychological well-being of orphans in Dar El Salaam, Tanzania. Acta Paediatr. 2002;91(4):459–65. https://doi.org/10.1080/080352502317371724.

    Article  CAS  PubMed  Google Scholar 

  26. Nabunya P, Ssewamala FM. The Effects of parental loss on the psychosocial wellbeing of AIDS-orphaned children living in AIDS-impacted communities: does gender matter? Child Youth Serv Rev. 2014;43:131–7. https://doi.org/10.1016/j.childyouth.2014.05.011.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Nyamukapa CA, Gregson S, Wambe M, Mushore P, Lopman B, Mupambireyi Z, Jukes MC. Causes and consequences of psychological distress among orphans in eastern Zimbabwe. AIDS Care. 2010;22(8):988–96. https://doi.org/10.1080/09540121003615061.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Puffer ES, Drabkin AS, Stashko AL, Broverman SA, Ogwang-Odhiambo RA, Sikkema KJ. Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya. J Pediatr Psychol. 2012;37(8):868–78. https://doi.org/10.1093/jpepsy/jss077.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kirkpatrick SM, Rojjanasrirat W, South BJ, Sindt JA, Williams LA. Assessment of emotional status of orphans and vulnerable children in Zambia. J Nurs Scholarsh. 2012;44(2):194–201. https://doi.org/10.1111/j.1547-5069.2012.01447.x.

    Article  PubMed  Google Scholar 

  30. Sengendo J, Nambi J. The psychological effect of orphanhood: a study of orphans in Rakai district. Health Transit Rev. 1997;7(Supplement):105–24.

    PubMed  Google Scholar 

  31. Sherr L, Croome N, Clucas C, Brown E. Differential effects of single and double parental death on child emotional functioning and daily life in South Africa. Child Welf. 2014;93(1):149–72.

    Google Scholar 

  32. Grant MJ, Yeatman S. The relationship between orphanhood and child fostering in sub-Saharan Africa, 1990s–2000s. Pop Stud-J Demog. 2012;66(3):279–95. https://doi.org/10.1080/00324728.2012.681682.

    Article  Google Scholar 

  33. Kamali A, Seeley JA, Nunn AJ, Kengeya-Kayondo JF, Ruberantwari A, Mulder DW. The orphan problem: Experience of a sub-Saharan Africa rural population in the AIDS epidemic. AIDS Care. 1996;8(5):509–16. https://doi.org/10.1080/09540129650125470.

    Article  CAS  PubMed  Google Scholar 

  34. O’Donnell K, Dorsey S, Gong W, Ostermann J, Whetten R, Cohen JA, Whetten K. Treating unresolved grief and posttraumatic stress symptoms in orphaned children in Tanzania: group-based trauma-focused cognitive behavioral therapy. J Trauma Stress. 2014;27(6):664–71. https://doi.org/10.1002/jts.21970.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Braitstein P, Ayaya S, Nyandiko WM, Kamanda A, Koech J, Gisore P, Ayuku DO. Nutritional status of orphaned and separated children and adolescents living in community and institutional environments in Uasin Gishu County, Kenya. PLoS ONE. 2013;8(7):E70054. https://doi.org/10.1371/journal.pone.0070054.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Oleke C, Blystad A, Fylkesnes K, Tumwine JK. Constraints to educational opportunities of orphans: a community-based study from northern Uganda. AIDS Care. 2007;19(3):361–8. https://doi.org/10.1080/09540120600677987.

    Article  CAS  PubMed  Google Scholar 

  37. Crampin AC, Floyd S, Glynn JR, Madise N, Nyondo A, Khondowe MM, Fine PE. The long-term impact of HIV and orphanhood on the mortality and physical well-being of children in rural Malawi. AIDS. 2003;17(3):389–97. https://doi.org/10.1097/00002030-200302140-00013.

    Article  PubMed  Google Scholar 

  38. Lindblade KA, Odhiambo F, Rosen DH, DeCock KM. Health and nutritional status of orphans. Trop Med Int Health. 2003;8(1):67–72. https://doi.org/10.1046/j.1365-3156.2003.00987.x.

    Article  PubMed  Google Scholar 

  39. Ntanda H, Olupot-Olupot P, Mugyenyi P, Kityo C, Lowes R, Cooper C, Mills E. Orphanhood predicts delayed access to care in Ugandan children. Pediatr Infect Dis J. 2009;28(2):153–5. https://doi.org/10.1097/inf.0b013e318184eeeb.

    Article  PubMed  Google Scholar 

  40. Kimani-Murage EW, Holding PA, Fotso J, Ezeh AC, Madise NJ, Kahurani EN, Zulu EM. Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya. J Urban Health. 2011;88(2):282–97. https://doi.org/10.1007/s11524-010-9491-z.

    Article  Google Scholar 

  41. Sarker M, Neckermann C, Muller O. Assessing the health status of young AIDS and other orphans in Kampala, Uganda. Trop Med Int Health. 2005;10(3):210–5. https://doi.org/10.1111/j.1365-3156.2004.01377.x.

    Article  PubMed  Google Scholar 

  42. Mkandawire P, Tenkorang E, Luginaah IN. Orphan status and time to first sex among adolescents in northern Malawi. AIDS Behav. 2013;17(3):939–50. https://doi.org/10.1007/s10461-011-0120-y.

    Article  PubMed  Google Scholar 

  43. Kikuchi K, Poudel KC, Muganda J, Sato T, Mutabazi V, Muhayimpundu R, et al. What makes orphans in Kigali, Rwanda, non-adherent to antiretroviral therapy? Perspectives of their caregivers. J Int AIDS Soc. 2014. https://doi.org/10.7448/ias.17.1.19310.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kikuchi K, Poudel KC, Muganda J, Majyambere A, Otsuka K, Sato T, Yasuoka J. High risk of ART non-adherence and delay of ART initiation among HIV positive double orphans in Kigali, Rwanda. PLoS ONE. 2012;7(7):E41998. https://doi.org/10.1371/journal.pone.0041998.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Van Rie A, Mupuala A, Dow A. Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo. Pediatrics. 2008;122(1):E123–8. https://doi.org/10.1542/peds.2007-2558.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Crea TM, Lombe M, Robertson LA, Dumba L, Mushati P, Makoni J, Gregson S. Asset ownership among households caring for orphans and vulnerable children in rural Zimbabwe: the influence of ownership on children’s health and social vulnerabilities. AIDS Care. 2013;25(1):126–32. https://doi.org/10.1080/09540121.2012.687812.

    Article  PubMed  Google Scholar 

  47. Hunter SS. Orphans as a window on the AIDS epidemic in sub-Saharan Africa: initial results and implications of a study in Uganda. Soc Sci Med. 1990;31(6):681–90. https://doi.org/10.1016/0277-9536(90)90250-v.

    Article  CAS  PubMed  Google Scholar 

  48. Hilhorst T, Liere MV, Ode AV, Koning KD. Impact of AIDS on rural livelihoods in Benue State, Nigeria. SAHARA J-J Soc Asp H. 2006;3(1):382–93. https://doi.org/10.1080/17290376.2006.9724864.

    Article  CAS  Google Scholar 

  49. Nyambedha EO, Wandibba S, Aagaard-Hansen J. Policy implications of the inadequate support systems for orphans in Western Kenya. Health Policy. 2001;58(1):83–96. https://doi.org/10.1016/s0168-8510(01)00145-2.

    Article  CAS  PubMed  Google Scholar 

  50. Ntozi JP, Mukiza-Gapere J. Care for AIDS orphans in Uganda: findings from focus group discussions. Health Transit Rev. 1995;5:245–52.

    PubMed  Google Scholar 

  51. Nyambedha EO. Vulnerability to HIV infection among Luo female adolescent orphans in Western Kenya. Afr J AIDS Res. 2007;6(3):287–95. https://doi.org/10.2989/16085900709490424.

    Article  PubMed  Google Scholar 

  52. Howard B, Matinhure N, Mccurdy SA, Johnson CA. Psychosocial disadvantage: preparation, grieving, remembrance and recovery for orphans in eastern Zimbabwe. Afr J AIDS Res. 2006;5(1):71–83. https://doi.org/10.2989/16085900609490368.

    Article  PubMed  Google Scholar 

  53. Govender K, Reardon C, Quinlan T, George G. Children’s psychosocial wellbeing in the context of HIV/AIDS and poverty: a comparative investigation of orphaned and non-orphaned children living in South Africa. BMC Public Health. 2014;14(1):615–28. https://doi.org/10.1186/1471-2458-14-615.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Hallfors DD, Cho H, Iritani BJ, Mapfumo J, Mpofu E, Luseno WK, January J. Preventing HIV by providing support for orphan girls to stay in school: does religion matter? Ethn Health. 2013;18(1):53–65. https://doi.org/10.1080/13557858.2012.694068.

    Article  PubMed  Google Scholar 

  55. Nyirenda M, Mcgrath N, Newell M. Gender differentials in the impact of parental death: adolescent’s sexual behaviour and risk of HIV infection in rural South Africa. Vulnerable Child Youth Stud. 2010;5(3):284–96. https://doi.org/10.1080/17450128.2010.507804.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Pascoe S, Langhaug L, Durawo J, Woelk G, Ferrand R, Jaffar S, Cowan F. Increased risk of HIV-infection among school-attending orphans in rural Zimbabwe. AIDS Care. 2010;22(2):206–20. https://doi.org/10.1080/09540120903111528.

    Article  CAS  PubMed  Google Scholar 

  57. Mmari K, Michaelis A, Kiro K. Risk and protective factors for HIV among orphans and non-orphans in Tanzania. Cult Health Sex. 2009;11(8):799–809. https://doi.org/10.1080/13691050902919085.

    Article  PubMed  Google Scholar 

  58. Birdthistle I, Floyd S, Nyagadza A, Mudziwapasi N, Gregson S, Glynn JR. Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe? Soc Sci Med. 2009;68(10):1810–8. https://doi.org/10.1016/j.socscimed.2009.02.035.

    Article  PubMed  Google Scholar 

  59. Birdthistle IJ, Floyd S, Machingura A, Mudziwapasi N, Gregson S, Glynn JR. From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. AIDS. 2008;22(6):759–66. https://doi.org/10.1097/qad.0b013e3282f4cac7.

    Article  PubMed  Google Scholar 

  60. Okawa S, Yasuoka J, Ishikawa N, Poudel KC, Ragi A, Jimba M. Perceived social support and the psychological well-being of AIDS orphans in urban Kenya. AIDS Care. 2011;23(9):1177–85. https://doi.org/10.1080/09540121.2011.554530.

    Article  PubMed  Google Scholar 

  61. Fournier B, Bridge A, Kennedy AP, Alibhai A, Konde-Lule J. Hear our voices: a photovoice project with children who are orphaned and living with HIV in a Ugandan group home. Child Youth Serv Rev. 2014;45:55–63. https://doi.org/10.1016/j.childyouth.2014.03.038.

    Article  Google Scholar 

  62. Funkquist Å, Eriksson B, Muula A. The vulnerability of orphans in Thyolo District, southern Malawi. Tanzan J Health Res. 2007;9(2):102–9. https://doi.org/10.4314/thrb.v9i2.14311.

    Article  CAS  Google Scholar 

  63. Howard BH, Phillips CV, Matinhure N, Goodman KJ, Mccurdy SA, Johnson CA. Barriers and incentives to orphan care in a time of AIDS and economic crisis: A cross-sectional survey of caregivers in rural Zimbabwe. BMC Public Health. 2006;6(1):27–38. https://doi.org/10.1186/1471-2458-6-27.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Mwakalobo AB. Implications of HIV/AIDS for rural livelihoods in Tanzania: the example of Rungwe District. Afr Stud Rev. 2007;50(03):51–73. https://doi.org/10.1353/arw.2008.0019.

    Article  Google Scholar 

  65. Juma M, Alaii J, Bartholomew LK, Askew I, Van Den Born B. Understanding orphan and non-orphan adolescents’ sexual risks in the context of poverty: a qualitative study in Nyanza Province, Kenya. BMC Int Health Hum Rights. 2013;13(1):32–9. https://doi.org/10.1186/1472-698x-13-32.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Fotso JC, Holding PA, Ezeh AC. Factors conveying resilience in the context of urban poverty: the case of orphans and vulnerable children in the informal settlements of Nairobi, Kenya. Child Adolesc Ment Health-UK. 2009;14(4):175–82. https://doi.org/10.1111/j.1475-3588.2009.00534.x.

    Article  Google Scholar 

  67. Ji G, Li L, Lin C, Sun S. The impact of HIV/AIDS on families and children-a study in China. AIDS (London, England). 2007;21(Suppl 8):S157.

    Article  Google Scholar 

  68. Ismayilova L, Ssewamala F, Mooers E, Nabunya P, Sheshadri S. Imagining the future: community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda. Child Youth Serv Rev. 2012;34(10):2042–51. https://doi.org/10.1016/j.childyouth.2012.06.010.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Evans DK, Miguel E. Orphans and schooling in Africa: a longitudinal analysis. Demography. 2007;44(1):35–57. https://doi.org/10.1353/dem.2007.0002.

    Article  PubMed  Google Scholar 

  70. Case A, Ardington C. The Impact of parental death on school outcomes: longitudinal evidence from South Africa. Demography. 2006;43(3):401–20. https://doi.org/10.1353/dem.2006.0022.

    Article  PubMed  Google Scholar 

  71. Nyamukapa C, Gregson S. Extended family’s and women’s roles in safeguarding orphans’ education in AIDS-afflicted rural Zimbabwe. Soc Sci Med. 2005;60(10):2155–67. https://doi.org/10.1016/j.socscimed.2004.10.005.

    Article  PubMed  Google Scholar 

  72. Pagnier J, Kürzinger ML, Kahn JG, Kone A, Hampshire R, Dye TD. Education among orphans and non-orphans in an urban area of Burkina Faso. Vulnerable Child Youth Stud. 2008;3(1):31–6. https://doi.org/10.1080/17450120701593688.

    Article  Google Scholar 

  73. Chege K, Kodero H, Benard M. The self-concept and academic performance of institutionalized and non-institutionalized HIV/AIDS orphaned children in Kisumu municipality. Educ Res Rev-Neth. 2009;4(3):106–10.

    Google Scholar 

  74. Ford K, Hosegood V. AIDS mortality and the mobility of children in KwaZulu Natal, South Africa. Demography. 2005;42(4):757–68. https://doi.org/10.1353/dem.2005.0029.

    Article  PubMed  Google Scholar 

  75. Pufall EL, Nyamukapa C, Robertson L, Mushore PG, Takaruza A, Gregson S. Migration as a risk factor for school dropout amongst children made vulnerable by HIV/AIDS: a prospective study in eastern Zimbabwe. Vulnerable Child Youth Stud. 2015;10(3):179–91. https://doi.org/10.1080/17450128.2015.1034799.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Migration and children. [Internet]. New York: United Nations Children’s Emergency Fund; 2016 [cited 2016 Aug 14]. https://www.unicef-irc.org/knowledge-pages/Migration-and-children.

  77. Evans R. Poverty, HIV, and barriers to education: street children’s experiences in Tanzania. Gend Dev. 2002;10(3):51–62. https://doi.org/10.1080/13552070215916.

    Article  Google Scholar 

  78. Cohen B. Urbanization in developing countries: Current trends, future projections, and key challenges for sustainability. Technol Soc. 2006;28(1–2):63–80. https://doi.org/10.1016/j.techsoc.2005.10.005.

    Article  Google Scholar 

  79. Curley J, Ssewamala F, Han C. Assets and educational outcomes: Child Development Accounts (CDAs) for orphaned children in Uganda. Child Youth Serv Rev. 2010;32(11):1585–90. https://doi.org/10.1016/j.childyouth.2009.07.016.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Poverty & equity [Internet]. Washington, DC: World Bank; 2016 [cited 2016 Jul 10]. http://povertydata.worldbank.org/poverty/region/SSA.

  81. Ssewamala FM, Alicea S, Bannon WM, Ismayilova L. A Novel economic intervention to reduce HIV risks among school-going AIDS orphans in rural Uganda. J Adolesc Health. 2008;42(1):102–4. https://doi.org/10.1016/j.jadohealth.2007.08.011.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Ssewamala FM, Han C, Neilands TB. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda. Soc Sci Med. 2009;69(2):191–8. https://doi.org/10.1016/j.socscimed.2009.05.019.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Ssewamala FM, Ismayilova L. Integrating children’s savings accounts in the care and support of orphaned adolescents in rural Uganda. Soc Serv Rev. 2009;83(3):453–72. https://doi.org/10.1086/605941.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Ssewamala FM, Ismayilova L, Mckay M, Sperber E, Bannon W, Alicea S. Gender and the effects of an economic empowerment program on attitudes toward sexual risk-taking among AIDS-orphaned adolescent youth in Uganda. J Adolesc Health. 2010;46(4):372–8. https://doi.org/10.1016/j.jadohealth.2009.08.010.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Ssewamala FM, Nabunya P, Ilic V, Mukasa MN, Ddamulira C. Relationship between family economic resources, psychosocial well-being, and educational preferences of AIDS-orphaned children in southern Uganda: baseline findings. Glob Soc Welf. 2015;2(2):75–86. https://doi.org/10.1007/s40609-015-0027-z.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Ssewamala FM, Karimli L, Han C, Ismayilova L. Social capital, savings, and educational performance of orphaned adolescents in Sub-Saharan Africa. Child Youth Serv Rev. 2010;32(12):1704–10. https://doi.org/10.1016/j.childyouth.2010.07.013.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Makumbi FE, Nakigozi G, Sekasanvu J, Lukabwe I, Kagaayi J, Lutalo T, Gray R. Incidence of orphanhood before and after implementation of a HIV care programme in Rakai, Uganda. Trop Med Int Health. 2012;17(8):E94–102. https://doi.org/10.1111/j.1365-3156.2012.03031.x.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Patel D, Matyanga P, Nyamundaya T, Chimedza D, Webb K, Engelsmann B. Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe. J Int AIDS Soc. 2012. https://doi.org/10.7448/ias.15.4.17404.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Chitiyo M, Changara DM, Chitiyo G. Providing psychosocial support to special needs children: a case of orphans and vulnerable children in Zimbabwe. Int J Educ Dev. 2008;28(4):384–92. https://doi.org/10.1016/j.ijedudev.2007.05.009.

    Article  Google Scholar 

  90. Cho H, Hallfors DD, Mbai II, Itindi J, Milimo BW, Halpern CT, Iritani BJ. Keeping adolescent orphans in school to prevent human immunodeficiency virus infection: Evidence from a randomized controlled trial in Kenya. J Adolesc Health. 2011;48(5):523–6. https://doi.org/10.1016/j.jadohealth.2010.08.007.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Hallfors DD, Cho H, Rusakaniko S, Mapfumo J, Iritani B, Zhang L, et al. The impact of school subsidies on HIV-related outcomes among adolescent female orphans. J Adolesc Health. 2015;56(1):79–84. https://doi.org/10.1016/j.jadohealth.2014.09.004.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.

    Google Scholar 

  93. McAlister AL, Perry CL, Parcel GS. How individuals, environments and health behaviors interact: Social cognitive theory. In: Glanz K, Lewis FM, Rimer BK, editors. Health behavior and health education: theory, research, and practice. San Francisco: Jossey-Bass; 2008. p. 167–88.

    Google Scholar 

  94. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Quart. 1988;15:351–77. https://doi.org/10.1177/109019818801500401.

    Article  CAS  Google Scholar 

  95. Raphael D. Social determinants of health: present status, unanswered questions and future directions. Int J Health Serv. 2006;36:651–77. https://doi.org/10.2190/3MW4-1EK3-DGRQ-2CRF.

    Article  PubMed  Google Scholar 

  96. Sallis JF, Glanz K. Physical activity and food environments: solutions to the obesity epidemic. Milbank Q. 2009;87:123–54. https://doi.org/10.1111/j.1468-0009.2009.00550.x.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. Health behavior and health education: theory, research, and practice. San Francisco: Jossey-Bass; 2008. p. 464–85.

    Google Scholar 

  98. Yancey AK. Building capacity to prevent and control chronic disease in underserved communities: expanding the wisdom of WISEWOMAN in intervening at the environmental level. J Womens Health (Larchmt). 2004;13:644–9. https://doi.org/10.1089/1540999041281052.

    Article  Google Scholar 

  99. Global health observatory data [Internet]. Geneva: World Health Organization; 2016 [cited 2016 Jul 10]. http://www.who.int/gho/hiv/en/.

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Correspondence to Tara Rava Zolnikov.

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Raymond, J.M., Zolnikov, T.R. AIDS-Affected Orphans in Sub-Saharan Africa: A Scoping Review on Outcome Differences in Rural and Urban Environments. AIDS Behav 22, 3429–3441 (2018). https://doi.org/10.1007/s10461-018-2134-1

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