Abstract:
Orphans and vulnerable children (OVC) affected by HIV/AIDS frequently experience placement/
residential changes, inconsistent caregivers, abuse, neglect, disruptions in their lives and several mental health
problems. This may lead to a disorder of emotional functioning, reactive attachment disorder (RAD), where the child
exhibits wary, watchful, and emotionally withdrawn. Despite its clinical importance, nothing is known about RAD
among OVC. This study investigated: (1) whether RAD symptoms can occur in children affected by HIV/AIDS; (2)
association between RAD and other psychiatric symptoms; (3) possible aetiological or contextual factors for high
RAD symptom; and (4) any interactive, cumulative effects between the aetiological or contextual factors (both risks
and protective) for higher RAD symptoms.
Method: In a cross-sectional survey, caregivers of 191 OVC and 100 non-OVC completed questionnaires on
mental health problems including RAD and contextual variables.
Results: The results demonstrated that RAD is present in OVC and that RAD symptoms may be as a result of
environmental factors. The study also found high levels of RAD comorbidity with other disorders including
depression, conduct problems and hyperactivity. Finally, the results indicate that experiencing more neglect and
psychological abuse among OVC increases their likelihood of exhibiting RAD symptoms five-fold.
Conclusion: The paper discusses the clinical implications of these findings for service development for this
vulnerable group in the community and concluded that among children affected by HIV/AIDS, RAD was not rare.
