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Table 2 Descriptive summary of the included studies

From: Effects of psychosocial interventions on children affected by parental HIV/AIDS: a meta-analysis on depression and anxiety

StudyLocation (dates of the study)Sample Size and CharacteristicsEvaluation DesignIntervention DescriptionMajor Findings
Murphy et al., 2015 [30]Los Angeles, USA37 mother-child dyads through HIV/AIDS service organization; Child M age 10.5 (7–14); Women M age 37.6RCT: Yes, waiting-list design;
Comparison: Standard Care;
Follow-ups: Baseline, after intervention, Retention: 100%.
Name: Children United with Buddies (CUB); Level: Group; Components: 3 sessions for children, (a) learn concrete coping strategies, especially communication with their mothers living with HIV (MLH); (b) obtain accurate and age-appropriate information on how HIV is not transmitted, and on HIV illness and treatment; and (c) feel less isolated, by providing connection to peers who share similar issues and promoting support for normalization and validation of fears and concerns. MLH attended the first two sessions with children and the third session paralleled; Duration: Weekly session, each session lasts 60–75 min; Deliverer: two pairs of facilitators held master’s degree in psychologyResults showed significant decreases in anxiety and worry for children in the intervention group and increases in happiness and knowledge regarding HIV/AIDS transmission.
Lin et al., 2014 [31]Central ChinaN = 124, children orphaned by AIDS (COA)RCT: Yes;Comparison: Standard care;
Follow-ups: Baseline, three-month posttest.
This psychological intervention program was designed to specifically help COA process their grief, cope with stress and discrimination, manage emotion, and reduce their psychological distress. Six weekly sessions (1.5–2.0 h) of group intervention focused on processing grief, reducing traumatic symptoms and psychological distress, and fostering hope about the future. Deliverer: a trained postgraduate student with a degree in family therapyAt the three-month post-test, children in both groups (intervention group and control group) reported significant reduction in trauma symptoms and demonstrated similar levels of hope. However, the intervention group reported significantly increased levels of grief processing and decreased levels of trauma symptoms, depression, and threat appraisal.
Eloff et al., 2014 [12]Tshwane, South Africa390 HIV+ women attending clinics and their children; Child M age 8.4 (6–10); Women M age 33.1;RCT: Yes;
Comparison: Standard Care;
Follow-ups: IP, 6-months,12-months, 18-months;
Retention: 84.6%.
Name: Parent-Child Group Intervention; Level: Group; Components: 14 separated interventions for mothers (on living with HIV and parenting) and children (on building self-esteem, enhancing interpersonal and practical life skills); 10 joint sessions (on healthy parent-child interaction); Duration: weekly session, each lasting 75 min; Deliverer: Community care workers.Intervention children reported a temporary increase in anxiety but did not report differences in depression. However, boys tend to gain greater benefit from the intervention than girls in reducing depression.
Rochat et al., 2014 [32]South Africa291 mothers living with HIV and their HIV-uninfected children aged 6–10 yearsRCT: No, pre-post design;
Comparison: Standard care; Follow-ups: Baseline, after intervention.
Name: Family centered, maternal HIV disclosure interventions; Level: Individual; Components: 1) a pre-disclosure stage when the counselor worked with the mother to prepare and train her towards disclosure; 2) a post-disclosure stage, when the mother was counseled on health promotion and custody planning. Duration: 6 sessions, over a six to eight-week period. Mothers attended all the sessions and children joined in the second and last sessions. 1–2 h in session 1,2, and 5, 2–3 h in sessions 3 and 4, less than 1 h in session 6. Deliverer: Lay counsellorThere was a significant decrease in CBCL total scores, including significant decreases in anxious-depressed, withdrawn-depressed. A significant moderating effect of disclosure type was revealed on withdrawn-depressed syndrome scores; thus, when compared to those who fully disclosed, children of mothers who partially disclosed had a greater decrease in withdrawn-depressed syndrome scores after intervention.
Keypour et al. 2011 [33]Iran15 adolescents (age = 13–18) and 15 HIV+ parentsRCT: No, pre-post design;
Comparison: Standard care;
Follow-ups: Baseline; after intervention, 3 months.
Name: Cognitive behavioral stress management training; Level: Group; Components: Adolescents interventions focuses on awareness about stress, relaxation, unhelpful thoughts, cognitive reconstruction, problem solving, assertiveness skill training, anger and time management (8 weekly sessions, 90 min each; 3 educational sessions for parents (parallel to first, fourth and eighth children’s session); Deliver: A child and adolescent psychiatristThe training improved adolescents’ emotional problems, including anxiety and depression.
Kumakech et al., 2009 [16]Mbarara District of southwestern Uganda326 Children (age = 10–15) who have lost one or both parents due to AIDS were selected using a multi-stage sampling procedureRCT: Yes;
Comparison: Standard care;
Follow-ups: Baseline, 10 weeks after intervention;
Retention: 91.4%.
Name: Peer-group support intervention; Level: Group; Components: a) introduction and relationships building; b) trust building and group discussion of problem solving, fears of orphanhood, and sources of satisfaction; c) self-esteem raising exercises. Duration: 16 sessions (over 10 weeks), each one lasts approximately 1 h; Deliverer: selected primary school teachers (supervised by a researcher and a counselor).The peer-group support intervention has a significant impact on anxiety, depression, and anger among AIDS orphans.
Kaufman et al., 2013 [34]China39 children orphaned by AIDSRCT: NO, Pre-post design;
Comparison: Standard care;
Follow ups: Baseline; 6- and 12- month follow-up;
Name: Community-based mental health counseling. Level: Individual,
Components: To improve communication skills for children and caretakers and reinforce children’s self-esteem including two joint sessions with caretakers. Two rounds of counseling (six sessions in round one, four sessions in round two, once a week for 90 min) were carried out over a one-year.
Deliverer: Trained community workers
There was a statistically significant improvement for the children on anxiety, but there was no statistically significant improvement on depression, with greatest gains immediately following the intervention.
O’Donnell et al., 2014 [35]Tanzania, East Africa64 orphaned childrenRCT: NO; Pre-post;
Follow-ups: Baseline, 3-month, and 12-month follow-up.
Name: group-based trauma-focused cognitive behavior therapy (TF-CBT)
Level: Group,
Components: a) a foundation for understanding how loss affects children and taught relaxation and coping skills (session 1–3). b) The trauma narrative (TN) (e.g. talking about memory and sharing in session 5–8) and processing (discuss feeling and support children). The last sessions (9–12) addressed grief-specific elements, each including a conjoint child–guardian activity.
Deliverer: Lay counselors with no prior mental health experiences.
Results: Children had reduced depression symptoms by the end of treatment, with improvements sustained at 3 and 12 months after treatment.