MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
Health Soc Care Community. 2010 May;18(3):264-71. doi: 10.1111/j.1365-2524.2009.00891.x. Epub 2009 Dec 21.
Caregivers of young children identified as HIV positive, residing in Agincourt, rural South Africa were advised of their child's status. How was this knowledge received, and how did it influence care-giving and support? Interviews were conducted in May to June 2008 with caregivers of HIV positive children aged 1-5 years, 1 year following the child's HIV test and disclosure of status. Drawing on data from 31 semi-structured questionnaires and 21 in-depth interviews, we describe caregivers' attitudes, reactions, fears and aspirations after learning a child's HIV status, the perceived usefulness of the knowledge, barriers to care-giving and support received. Sociodemographic data collected through the questionnaire were analysed using Stata. Qualitative data were coded in NVIVO 8 and analysed inductively to identify themes and their repetitions and variations. Although almost half of the caregivers responded negatively initially, 1 year later, almost all had accepted and valued knowing their child's HIV status as this had enhanced their competency in care-giving. Counselling from health providers and personal spirituality helped caregivers to accept the child's status and cope with its implications. Most caregivers had high aspirations for the child's future, despite some expressed difficulties associated with care-giving, including financial constraints, information gaps and barriers to healthcare. The results indicate an opportunity for paediatric HIV screening in communities with high HIV prevalence. This would facilitate early uptake of available interventions, so enhancing the survival of HIV positive children.
我们告知了居住在南非农村阿格因库尔的、被诊断为 HIV 阳性的幼儿的看护者他们孩子的状况。他们是如何接受这一信息的？这对他们的护理和支持产生了什么影响？2008 年 5 月至 6 月，我们对 31 名 1-5 岁 HIV 阳性儿童的看护者进行了访谈，这些儿童在接受 HIV 检测和告知状况后 1 年。我们根据 31 份半结构化问卷和 21 份深入访谈的数据，描述了看护者在得知孩子 HIV 状况后的态度、反应、恐惧和愿望，以及他们对知识的感知有用性、护理和支持方面的障碍。通过问卷收集的社会人口数据使用 Stata 进行分析。在 NVIVO 8 中对定性数据进行编码，并进行归纳分析，以确定主题及其重复和变化。尽管近一半的看护者最初反应消极，但 1 年后，几乎所有人都接受并重视了解孩子的 HIV 状况，因为这增强了他们的护理能力。卫生服务提供者的咨询和个人的精神信仰帮助看护者接受孩子的状况并应对其影响。尽管一些看护者表示在护理方面存在经济限制、信息差距和医疗保健障碍等困难，但大多数看护者对孩子的未来抱有很高的期望。研究结果表明，在 HIV 流行率较高的社区中，为儿童提供 HIV 筛查是一个机会。这将促进早期采用现有的干预措施，从而提高 HIV 阳性儿童的生存率。
