Lachman Jamie M, Cluver Lucie D, Boyes Mark E, Kuo Caroline, Casale Marisa
a Department of Social Policy and Intervention, Centre for Evidence-Based Intervention , University of Oxford , Oxford , UK.
AIDS Care. 2014;26(3):304-13. doi: 10.1080/09540121.2013.825368. Epub 2013 Aug 12.
Families affected by HIV/AIDS in the developing world experience higher risks of psychosocial problems than nonaffected families. Positive parenting behavior may buffer against the negative impact of child AIDS-orphanhood and caregiver AIDS-sickness on child well-being. Although there is substantial literature regarding the predictors of parenting behavior in Western populations, there is insufficient evidence on HIV/AIDS as a risk factor for poor parenting in low- and middle-income countries. This paper examines the relationship between HIV/AIDS and positive parenting by comparing HIV/AIDS-affected and nonaffected caregiver-child dyads (n=2477) from a cross-sectional survey in KwaZulu-Natal, South Africa (27.7% AIDS-ill caregivers; 7.4% child AIDS-orphanhood). Multiple mediation analyses tested an ecological model with poverty, caregiver depression, perceived social support, and child behavior problems as potential mediators of the association of HIV/AIDS with positive parenting. Results indicate that familial HIV/AIDS's association to reduced positive parenting was consistent with mediation by poverty, caregiver depression, and child behavior problems. Parenting interventions that situate positive parenting within a wider ecological framework by improving child behavior problems and caregiver depression may buffer against risks for poor child mental and physical health outcomes in families affected by HIV/AIDS and poverty.
在发展中世界,受艾滋病毒/艾滋病影响的家庭比未受影响的家庭面临更高的心理社会问题风险。积极的养育行为可能缓冲儿童艾滋病孤儿身份和照顾者艾滋病患病对儿童幸福的负面影响。虽然有大量关于西方人群养育行为预测因素的文献,但在低收入和中等收入国家,关于艾滋病毒/艾滋病作为不良养育风险因素的证据不足。本文通过比较南非夸祖鲁-纳塔尔省一项横断面调查中受艾滋病毒/艾滋病影响和未受影响的照顾者-儿童二元组(n = 2477),研究了艾滋病毒/艾滋病与积极养育之间的关系(27.7%的照顾者患有艾滋病;7.4%的儿童为艾滋病孤儿)。多重中介分析测试了一个生态模型,其中贫困、照顾者抑郁、感知社会支持和儿童行为问题作为艾滋病毒/艾滋病与积极养育关联的潜在中介因素。结果表明,家庭艾滋病毒/艾滋病与积极养育减少之间的关联与贫困、照顾者抑郁和儿童行为问题的中介作用一致。通过改善儿童行为问题和照顾者抑郁,将积极养育置于更广泛生态框架内的养育干预措施,可能缓冲受艾滋病毒/艾滋病和贫困影响家庭中儿童心理和身体健康不良结果的风险。