1. WHEN TIME DOESN’T HEAL: CHILDHOOD TRAUMATIC GRIEF AMONG ORPHANS IN RURAL ZAMBIA Lisa F Langhaug, PhD Adrian Gschwend, Katharin Wespi, Pia Amman International AIDS Conference, Washington DC, July 2012

2. 2  Across sub-Saharan Africa, the HIV epidemic has orphaned more than 15 million children  Children’s experience of their loss remains understudied in sub-Saharan Africa This is particularly true of childhood traumatic grief which has been shown to be psychologically & medically debilitating.  Childhood traumatic grief was measured in a longitudinal study of orphans and vulnerable children in rural Zambia INTRODUCTION

3. Trained gender-matched interviewer-administered paper questionnaires METHODS 722 respondents completed R5 (12-20 yrs) 376 were orphans (46% female, 44.1% orphaned by AIDS) 346 had lost parent(s) 1 or more years before 310 completed all questions in this analysis

4. Childhood Traumatic Grief Based on Expanded Grief Inventory (Layne, 2001) Asked to report on feelings surrounding parental loss in the past 4 weeks Likert scale: Never (0), Rarely (1), Sometimes (2), Often (3), and Always (4) Grief was classified as traumatic if respondent had a mean score of 2. Other scales focused on Caregiver attachment, Household distribution of effects, daily stress, peer victimization, and Child Depression Inventory Factors surrounding parental death All scales were translated and culturally adapted Multiple hierarchical regression was used to examine predictors of Childhood Traumatic Grief MEASURES & ANALYSIS

5. 5  Most children had lost their parents some time ago Mean number of years since their loss was 7.6 years (SD=4.1 years)  One-third (30.2%) of orphans showed levels of childhood traumatic grief Double orphans reported significantly higher levels of grief than single orphans (r=0.12) CTG is associated with child depression, suicidal thoughts, & somatic complaints RESULTS

6. PREDICTORS OF CHILDHOOD TRAUMATIC GRIEF 22% of grief is explained by these variables

7. 7  High levels of enduring grief in children that have lost their parents which leads to debilitating effects.  Critical role for community-based initiatives that reach the household to play in alleviating this grief Household mobility after a parent’s death Within household discrimination Daily stressors Victimization and bullying CONCLUSION

8. THANK YOU ACKNOWLEDGEMENTS SWISS ACADEMY FOR DEVELOPMENT Adrian Gschwend, Katharin Wespi, Pia Ammann CHILDFUND-ZAMBIA David Mwyia REPSSI Kelvin Ngoma, Sebastian Chikuta,