Mundell Jonathan P, Visser Maretha J, Makin Jennifer D, Kershaw Trace S, Forsyth Brian W C, Jeffery Bridget, Sikkema Kathleen J
MRC Unit for Maternal and Infant Health Care Strategies, Department of Psychology, University of Pretoria, Pretoria, South Africa.
Women Health. 2011 Aug 31;51(6):546-65. doi: 10.1080/03630242.2011.606356.
The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p<0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t=2.68, p<0.05) and lower levels of avoidant coping (t=-2.02, p<0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t=2.11, p<0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time.
本研究的作者评估了一项针对新诊断出感染艾滋病毒的南非孕妇的、为期10节的结构化心理社会支持小组干预措施。预计参与者在艾滋病毒披露、自尊、积极应对和积极社会支持方面会有所增加,在抑郁、回避应对和消极社会支持方面会有所减少。2005年4月至2006年9月期间,从茨瓦内镇的四家产前诊所招募了361名感染艾滋病毒的孕妇。采用准实验设计,在基线以及干预后两个月和八个月进行评估。进行了一系列随机效应回归分析,将三个评估点视为时间的随机效应。在两次随访中,干预组的披露率均显著高于对照组(p<0.001)。与第一次随访时的对照组相比,干预组表现出更高水平的积极应对(t=2.68,p<0.05)和更低水平的回避应对(t=-2.02,p<0.05),并且至少参加了一半干预课程的人自尊有所改善(t=2.11,p<0.05)。在资源有限的环境中为新感染艾滋病毒的孕妇量身定制的小组干预措施可能会加速适应艾滋病毒感染状况的过程,但随着时间推移可能不会带来可持续的益处。