科研之友
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摘要
Objectives:Sub-Saharan Africa has large populations of HIV-infected parents who need support to raise their HIV-uninfected children. This research evaluates the Amagugu Intervention%26apos; aimed at supporting mothers to disclose their own HIV diagnosis to their HIV-uninfected children.Design:Uncontrolled pre and post-intervention evaluation.Setting:Africa Centre for Health and Population Studies, South Africa.Participants:Two hundred and eighty-one HIV-infected women and their HIV-uninfected children aged 6-10 years.Intervention:This lay counsellor-led intervention included six sessions conducted with mothers at home, providing printed materials and child-friendly activities to support disclosure of their diagnosis.Main outcome measure:The primary outcome was disclosure to the child (full, partial, none). The secondary outcomes included maternal mental health (General Health Questionnaire) and child mental health (Child Behaviour Checklist).Results:One hundred and seventy-one (60%) women fully%26apos; disclosed and 110 (40%) women partially%26apos; disclosed their HIV status to their child. Women who perceived their health to be excellent were less likely to fully%26apos; disclose compared to those considering their health to be poorer [adjusted odds ratio 0.48 (0.28-0.95), P=0.11]. Compared to those not in a current partnership, those with a current partner were almost three times more likely to fully%26apos; disclose [adjusted odds ratio 2.92 (1.33-6.40), P=0.008]. Mothers reported that most children reacted calmly to full%26apos; (79%) or partial%26apos; disclosure (83%). Compared to partial%26apos; disclosure, full%26apos; disclosure was associated with more children asking questions about maternal death (18 versus 8%).Conclusions:This intervention is acceptable in resource-limited settings and shows promise. Further research using a controlled design is needed to test this intervention.
- 出版日期2014-7
