Partners In Health, Boston, MA, USA.
Soc Sci Med. 2012 May;74(10):1494-503. doi: 10.1016/j.socscimed.2012.01.022. Epub 2012 Mar 6.
Given the increased access of antiretroviral therapy (ART) throughout the developing world, what was once a terminal illness is now a chronic disease for those receiving treatment. This requires a paradigmatic shift in service provision for those affected by HIV/AIDS in low-resource settings. Although there is a need for psychosocial support interventions for HIV-affected youth and their caregivers, to date there has been limited empirical evidence on the effectiveness of curriculum-based psychosocial support groups in HIV-affected families in low-income countries. Therefore, the purpose of this study is to examine the feasibility and assess the preliminary effectiveness of a psychosocial support group intervention for HIV-affected youth and their caregivers in central Haiti. The study was conducted at six Partners In Health-affiliated sites between February 2006 and September 2008 and included quantitative as well as qualitative methods. HIV-affected youth (n = 168) and their caregivers (n = 130) completed a baseline structured questionnaire prior to participation in a psychosocial support group intervention. Ninety-five percent of families completed the intervention and a follow-up questionnaire. Psychological symptoms, psychosocial functioning, social support, and HIV-related stigma at baseline were compared with outcomes one year later. Qualitative methods were also used to assess the participants' perspectives of the intervention. Comparing pre- and post-intervention assessment, youth affected by HIV experienced decreased psychological symptoms as well as improved psychosocial functioning and social support. Caregivers (95% HIV-positive) demonstrated a significant reduction in depressive symptoms, improved social support, and decreased HIV-related stigma. Although further study is needed to assess effectiveness in a randomized controlled trial, corroborative findings from qualitative data reflected reduced psychological distress, less social isolation and greater hope for the future for families affected by HIV/AIDS following the intervention.
随着抗逆转录病毒疗法（ART）在发展中国家的普及，对于接受治疗的人来说，曾经的绝症现在变成了慢性病。这需要在资源匮乏环境下为受艾滋病毒/艾滋病影响的人提供服务的范式发生转变。尽管艾滋病毒感染青年及其照顾者需要心理社会支持干预，但迄今为止，关于在低收入国家受艾滋病毒感染家庭中基于课程的心理社会支持小组对艾滋病毒感染青年及其照顾者的有效性的实证证据有限。因此，本研究的目的是检验和评估在海地中部为受艾滋病毒影响的青年及其照顾者提供心理社会支持小组干预的可行性和初步效果。该研究于 2006 年 2 月至 2008 年 9 月在六个健康伙伴附属点进行，采用定量和定性方法。在参加心理社会支持小组干预之前，受艾滋病毒影响的青年（n=168）及其照顾者（n=130）完成了基线结构化问卷。95%的家庭完成了干预和随访问卷。在基线时比较了心理症状、心理社会功能、社会支持和与艾滋病毒相关的耻辱感，一年后评估了结果。还使用定性方法评估了参与者对干预的看法。与干预前和干预后评估相比，受艾滋病毒影响的青年的心理症状减少，心理社会功能和社会支持改善。照顾者（95%艾滋病毒阳性）的抑郁症状显著减轻，社会支持增加，与艾滋病毒相关的耻辱感减少。尽管需要进一步的研究来评估随机对照试验中的效果，但来自定性数据的补充性发现反映出，在干预后，受艾滋病毒/艾滋病影响的家庭的心理困扰减少，社会孤立减少，对未来的希望增加。
