Social Support/Network, Religiosity, and Depression Among Older Caregivers of HIV/AIDS Children

Overview: This cross-sectional study explored the relationship between social support/network, religiosity and depression among 100 older caregivers of HIV/AIDS children in rural Namibia. By utilizing the hierarchical regression method, this study found that higher levels of social support/network and intrinsic religiosity were significantly associated with lower levels of depressive symptoms.Proposal text: Background/Rationale
Namibia has the highest HIV prevalence rate (13%) worldwide (SOS Namibia, 2020). According to the UNAIDS (2019), 344,055 orphans and vulnerable children have been affected as a direct result of the AIDS crisis. Evidence suggested that the AIDS epidemic has had an increasingly deleterious impact on the well-being of older adults, especially grandparents and great grandparents in sub-Saharan Africa because they have had to take on both primary caregiving and primary breadwinning roles of their kin (Kuo & Operario, 2011).

Methods
This study recruited 100 older adults (age 60+) who were caring for at least one child or grandchild living with HIV/AIDS in the Omusati region of rural Namibia. A structured survey questionnaire was created in English first, and a bilingual researcher who speaks Oshiwambo and English translated it into Oshiwambo. The 18-Item Lubben Social Network Scale (Lubben, 1988) was used to measure participants’ social support/network size ( = .82). To measure level of religiosity, the Duke University Religion Index (Koenig et al., 1997) was employed ( = .93). The Geriatric Depression Scale-Short Form (Yesavage et al., 1983) was employed to measure depression (=.88). This study also used five socio-demographic variables as control variables: age, gender, monthly income, marital status, and self-rated health.

Results
Participants’ mean age was 71 years (SD = 7.59). About 65% were female, and 37% were married. Most (92%) participants earned between N$501 and N$1,500 Namibian dollars monthly which corresponded to roughly $36 to $108 U.S. dollars (The Currency Converter, 2019). More than half indicated that they had excellent (17.2%) or good (38.4%) health conditions. The bivariate correlations among the main study variables indicated that depressive symptoms were negatively and significantly associated with gender (r = -0.23, p ≤ .05), self-rated health (r = -0.37, p ≤ .001), religiosity (r = -0.39, p ≤ .001), social support from neighbors (r = -0.45, p ≤ .001), and social support from friends (r = -.031, p ≤ .01). The hierarchical multivariate regression analysis method was used to test two hypotheses. As hypothesized, results indicated that higher levels of social network were significantly associated with lower levels of depressive symptoms (from family B = -0.26, SE = 0.13, p ≤ .05; from neighbors B = -0.18, SE = 0.06, p ≤ .01; from friends B = -0.14, SE = 0.05, p ≤ .01). Also, higher levels of religiosity were significantly related to lower levels of depressive symptoms (B = -0.46, SE = 0.13, p ≤ .001). Age, monthly household income, and marital status were not significantly related to depressive symptoms among this sample.

Conclusions
This study examined the role of social support/network and religiosity in predicting depressive symptoms among older caregivers. The study found that older caregivers who had higher levels of social support/network and intrinsic religiosity presented significantly lower levels of depressive symptoms. This study suggests the need for mental health professionals in Namibia to invest in and employ evidence-based social support/network and religious coping interventions for older caregivers of children with HIV/AIDS.