Künzel M, Kind C
Neonatologie, Frauenklinik, Kantonsspital St. Gallen.
Schweiz Med Wochenschr. 1992 Apr 4;122(14):503-10.
The social situation (placements, material conditions, needs) of children of HIV-infected mothers living in Switzerland was studied and their future needs were estimated.
Data were gathered by anonymous questionnaires mailed to the primary care physicians of the children of HIV-infected mothers registered in the Swiss Neonatal HIV Study. The physicians handed a copy to the parents or guardians.
The social situation could be adequately evaluated for 84 children. With respect to the proportion of mothers with a history of intravenous drug use (75%) or of foreign origin (19%), the children did not differ significantly from the whole population represented in the Swiss Neonatal HIV Study. Of a total of 3154 months, the children spent 75% with their natural mother, 14% with other family members, 6% in a foster family, 3% in a foster home and 2% with adoptive parents. At the time of the study 32 children (38%) could not be cared for by their own mother. The cumulative probability (by the Kaplan-Meier method) of continuing care by the mother was estimated at 78%, 70%, 60% and 50% for an age of 12, 24, 36 and 48 months respectively. Maternal reasons for placement in foster care were: enrollment in an institutional drug withdrawal program (11), neglect (8), death (8) or illness (5). The following ways of improving social conditions were identified: social acceptance without discrimination, early planning of the future care of children in anticipation of the imminent disruption of the family, financial support, assistance in baby sitting and support groups for parents and guardians.
A minimum annual requirement of 25 new foster care places for children of HIV-infected mothers can be estimated--assuming a stable annual incidence of some 50 deliveries of seropositive women in Switzerland. For primary care physicians it is a major challenge to stay sufficiently informed about the ever changing social situation in order to identify the often wide variety of assistance needed by the family. The quality and coordination of medical and psychosocial care for families confronted with HIV infection definitely needs improvement, especially outside metropolitan areas.
研究瑞士感染艾滋病毒母亲的子女的社会状况（安置情况、物质条件、需求），并估计他们未来的需求。
通过向瑞士新生儿艾滋病毒研究中登记的感染艾滋病毒母亲的子女的初级保健医生邮寄匿名问卷收集数据。医生将问卷副本交给父母或监护人。
对84名儿童的社会状况进行了充分评估。就有静脉注射吸毒史的母亲比例（75%）或外国血统的母亲比例（19%）而言，这些儿童与瑞士新生儿艾滋病毒研究中所代表的全体人群没有显著差异。在总共3154个月中，这些儿童75%的时间与亲生母亲在一起，14%的时间与其他家庭成员在一起，6%的时间在寄养家庭，3%的时间在寄养机构，2%的时间与养父母在一起。在研究时，32名儿童（38%）无法由自己的母亲照顾。采用Kaplan-Meier方法估计，母亲持续照顾的累积概率在儿童12、24、36和48个月时分别为78%、70%、60%和50%。将儿童安置在寄养机构的母亲原因有：参加机构戒毒项目（11例）、疏忽（8例）、死亡（8例）或患病（5例）。确定了以下改善社会状况的方法：无歧视的社会接纳、在家庭即将破裂之前尽早规划儿童的未来照料、经济支持、临时保姆协助以及为父母和监护人提供支持小组。
假设瑞士每年血清反应阳性妇女分娩约50例的发病率稳定，可以估计每年至少需要25个新的寄养名额用于感染艾滋病毒母亲的子女。对于初级保健医生来说，充分了解不断变化的社会状况以确定家庭经常需要的各种援助是一项重大挑战。面对艾滋病毒感染的家庭的医疗和心理社会护理的质量和协调肯定需要改善，尤其是在大都市地区以外。
