Bachmann Max O, Booysen Frederick L R
Department of Community Health, University of the Free State, PO Box 339(G52), Bloemfontein 9300, South Africa.
BMC Public Health. 2003 Apr 1;3:14. doi: 10.1186/1471-2458-3-14.
South African households are severely affected by human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) but health and economic impacts have not been quantified in controlled cohort studies.
We compared households with an HIV-infected member, and unaffected neighbouring households, in one rural and one urban area in Free State province, South Africa. Interviews were conducted with one key informant in each household, at baseline and six months later. We studied 1913 members of 404 households, with 94% and 96% follow up, respectively. Household and individual level analyses were done.
Members of affected households, compared to members of unaffected households, were independently more likely to be continuously ill (adjusted odds ratio (OR) 2.1, 95% CI 1.3-3.4 at follow up), and to die (adjusted OR 3.4, 95% CI 1.0-11), mainly due to infectious diseases. Government clinics and hospitals were the main sources of health care. Affected households were poorer than unaffected households at baseline (relative income per person 0.61, 95% CI 0.49-0.76). Over six months expenditure and income decreased more rapidly in affected than in unaffected households (baseline-adjusted relative expenditure 0.86, 95% CI 0.75-0.99 and income 0.89, 95% CI 0.75-1.05). Baseline morbidity was independently associated with lower income and expenditure at baseline but not with changes over six months.
HIV/AIDS affects the health and wealth of households as well as infected individuals, aggravating pre-existing poverty.
南非家庭深受人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）的影响，但在对照队列研究中，其对健康和经济的影响尚未得到量化。
我们在南非自由邦省的一个农村地区和一个城市地区，对有HIV感染成员的家庭以及未受影响的相邻家庭进行了比较。在基线期和六个月后，对每个家庭的一名关键信息提供者进行了访谈。我们研究了404个家庭的1913名成员，随访率分别为94%和96%。进行了家庭和个人层面的分析。
与未受影响家庭的成员相比，受影响家庭的成员更易持续患病（随访时调整后的优势比（OR）为2.1，95%置信区间为1.3 - 3.4），且更易死亡（调整后的OR为3.4，95%置信区间为1.0 - 11），主要死因是传染病。政府诊所和医院是主要的医疗保健来源。在基线期，受影响家庭比未受影响家庭更贫困（人均相对收入为0.61，95%置信区间为0.49 - 0.76）。在六个月的时间里，受影响家庭的支出和收入下降速度比未受影响家庭更快（基线调整后的相对支出为0.86，95%置信区间为0.75 - 0.99；收入为0.89，95%置信区间为0.75 - 1.05）。基线发病率与基线期较低的收入和支出独立相关，但与六个月内的变化无关。
HIV/AIDS不仅影响受感染个体，还影响家庭的健康和财富，加剧了原有的贫困状况。
