Maternal well-being, mother-child interaction and child psychosocial outcome in the context of HIV/AIDS : a literature review with a keen eye on sub-Saharan Africa

Abstract

The paper reviews the psychosocial literature regarding the impact of maternal HIV on mothers and their uninfected children. Drawing on the ecological theory of Urie Bronfenbrenner, the review proposes a framework that both demonstrates the link between maternal HIV and child psychosocial outcome, and examines the pathways that account for this relationship. Maternal HIV has been found to potentially affect a mother’s well-being negatively through a host of mediation factors associated with her infection. These factors affect a mother’s ability to be sensitive and responsive towards her child, influencing on attachment security, and thereby the quality of the mother-child interaction. One important finding appearing from this review is that children of HIV-infected mothers are at greater risk for psychosocial problems compared to children of non-infected mothers. An important channel through which child psychosocial problems emerge is the quality of the mother-child interaction. However, some studies reports that both children of infected and non-infected mothers are in the clinical range of concern, which draws attention to the fact that these children and their mothers all originate from high-risk environments. On the optimistic side, many HIV-infected mothers and their children cope well in face of adversity, which speaks for the presence of resilience factors. One particular resilience factor studied in this review is the support of the extended family system. The majority of the literature reviewed is from studies in the Western world, but the focus in the discussion takes into consideration the sub-Saharan African context. Based on the findings from the literature reviewed, intervention programs are recommended taking into consideration the sub-Saharan African context. Also, the findings are used for the recommendation for further research in sub-Saharan Africa.