Delva Wim, Vercoutere An, Loua Catherine, Lamah Jonas, Vansteelandt Stijn, De Koker Petra, Claeys Patricia, Temmerman Marleen, Annemans Lieven
International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
AIDS Care. 2009 Dec;21(12):1490-8. doi: 10.1080/09540120902887235.
Over the past decade, the effects of AIDS-related parental death on children's socio-economic, educational and psychological well-being have become apparent. Most studies, however, have compared the plight of so-called AIDS orphans with non-orphaned children only. Consequently, such study designs are unable to establish if the AIDS-related cause of death of the parents confers effects additional to those of parent-bereavement. We therefore conducted a cross-sectional survey to assess the psychological well-being and socio-economic hardship among 140 non-orphaned children, 133 children orphaned by causes other than AIDS (O) and 124 children orphaned by AIDS (O-A) in Conakry, N'Zerekore and the villages around N'Zerekore, Guinea. Multi-way analysis of variance and multiple (ordinal) logistic regression models were applied to measure the association between the orphan status and psychological well-being, school attendance, economic activities, frequency of going to bed hungry and sleeping commodity. After adjustment for confounding factors, the psychological well-being score (PWS) was significantly lower among AIDS-orphaned children than among O (P<0.001). Additionally, AIDS-orphaned children were more likely to be engaged in economic activities (adjusted odds ratio (AOR) = 3.04; 95% CI: 1.45-6.36) and to go to bed hungry on a daily basis (AOR = 2.73; 95% CI: 1.24-6.02) than other orphans. The differences in school attendance and the proportion of children with a bed or couch to sleep between AIDS-orphaned children and O were not statistically significant. This situation calls for sustainable and holistic approaches to ensure the psychological and socio-economic stability of AIDS orphans and other vulnerable children.
在过去十年中，与艾滋病相关的父母死亡对儿童社会经济、教育及心理健康的影响已变得显而易见。然而，大多数研究仅将所谓艾滋病孤儿的困境与非孤儿儿童进行比较。因此，此类研究设计无法确定父母因艾滋病死亡这一原因是否会带来除父母丧亲之外的其他影响。为此，我们在几内亚的科纳克里、恩泽雷科雷以及恩泽雷科雷周边村庄开展了一项横断面调查，以评估140名非孤儿儿童、133名因艾滋病以外原因成为孤儿的儿童（O）以及124名因艾滋病成为孤儿的儿童（O-A）的心理健康状况和社会经济困境。我们运用多因素方差分析和多重（有序）逻辑回归模型来衡量孤儿身份与心理健康、上学情况、经济活动、挨饿上床睡觉频率以及睡眠用品之间的关联。在对混杂因素进行调整后，艾滋病孤儿的心理健康得分（PWS）显著低于非艾滋病孤儿（P<0.001）。此外，与其他孤儿相比，艾滋病孤儿更有可能参与经济活动（调整后的优势比（AOR）=3.04；95%置信区间：1.45-6.36），并且每天挨饿上床睡觉的可能性更大（AOR = 2.73；95%置信区间：1.24-6.02）。艾滋病孤儿与非艾滋病孤儿在上学情况以及拥有床铺或睡椅睡觉的儿童比例方面的差异无统计学意义。这种情况需要采取可持续的整体方法，以确保艾滋病孤儿和其他弱势儿童的心理及社会经济稳定。
