Disability, social functioning and school inclusion among older children and adolescents living with HIV in Zimbabwe

Ruramayi Rukuni*, Grace McHugh, Edith Majonga, Katharina Kranzer, Hilda Mujuru, Shungu Munyati, Kusum Nathoo, Celia L Gregson, Hannah Kuper, Rashida A Ferrand

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

12 Citations (Scopus)
228 Downloads (Pure)


OBJECTIVE: Increasing numbers of children with HIV are surviving to adolescence and encountering multiple clinical and social consequences of longstanding HIV infection. We aimed to investigate the association between HIV and disability, social functioning and school inclusion among 6 to 16 year-olds in Zimbabwe.

METHODS: HIV-infected children receiving antiretroviral therapy from a public sector HIV clinic, and HIV-uninfected children attending primary care clinics in the same catchment area were recruited. Standardised questionnaires were used to collect sociodemographic, social functioning and disability data. Multivariable logistic regression was used to assess the relationship between HIV status and disability and functioning.

RESULTS: We recruited 202 HIV-infected and 285 HIV-uninfected children. There was no difference in age and gender between the two groups, but a higher proportion of HIV-infected children were orphaned. The prevalence of any disability was higher in HIV-infected than uninfected children (37.6% vs. 18.5%, p<0.001). HIV-infected children were more likely to report anxiety (adjusted odds ratio (aOR) 4.4; 95% CI 2.4, 8.1), low mood (aOR 4.2; 2.1, 8.4) and difficulty forming friendships (aOR 14.8; 1.9, 116.6) than uninfected children. Children with HIV also reported more missed school days, repeating a school year and social exclusion in class. These associations remained apparent when comparing children with HIV and disability to those with HIV but no disabilities.

CONCLUSIONS: Children with HIV commonly experience disabilities and this is associated with social and educational exclusion. Rehabilitation and support services are needed to facilitate educational attainment and social participation in this group. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)149-155
Number of pages7
JournalTropical Medicine and International Health
Issue number2
Early online date26 Dec 2017
Publication statusPublished - 1 Feb 2018


  • disability
  • adolescents
  • children
  • Africa
  • HIV
  • social functioning


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