This paper outlines the findings of the psychosocial and psychological literature on the impact of mothers and primary caregivers' HIV infection on maternal well-being, childcare and child adjustment. Drawing on an ecological approach, the paper outlines a model that both demonstrates the link between parental HIV/AIDS and child outcome, and examines the pathways that account for this relationship. These include personal, familial and environmental factors. Some of the key findings that emerge from the literature are that children of HIV positive mothers are at greater risk for emotional and psychological problems than children of uninfected mothers, especially internalising problems such as depression. However, children in poor, affected communities also experience detrimental developmental effects, indicating that HIV/AIDS typically serves as an added stressor in already at-risk communities. Further, disruptions to parental monitoring and the quality of the parent-child relationship are a key pathway whereby these impacts are felt, and are more likely where maternal HIV infection has progressed to AIDS. It is recommended that policy responses take cognisance of children's contexts and the pathways to child outcomes when attempting to respond to the HIV/AIDS epidemic.
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