Rochat Tamsen J, Arteche Adriane X, Stein Alan, Mkwanazi Ntombizodumo, Bland Ruth M
aAfrica Centre for Health and Population Studies, University of KwaZulu-Natal bDepartment of Psychology, Stellenbosch University, South Africa cDepartment of Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil dSection of Child and Adolescent Psychiatry, Department of Psychiatry, Oxford University, Oxford, UK eSchool of Public Health, University of Witwatersrand, Johannesburg fAfrica Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba gSchool of Public Health, University of Witwatersrand, Johannesburg hAfrica Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa iRoyal Hospital for Sick Children, University of Glasgow, Glasgow, UK jSchool of Public Health, University of Witwatersrand, Johannesburg, South Africa.
AIDS. 2014 Jul;28 Suppl 3:S331-41. doi: 10.1097/QAD.0000000000000333.
Sub-Saharan Africa has large populations of HIV-infected parents who need support to raise their HIV-uninfected children. This research evaluates the 'Amagugu Intervention' aimed at supporting mothers to disclose their own HIV diagnosis to their HIV-uninfected children.
Uncontrolled pre and post-intervention evaluation.
Africa Centre for Health and Population Studies, South Africa.
Two hundred and eighty-one HIV-infected women and their HIV-uninfected children aged 6-10 years.
This lay counsellor-led intervention included six sessions conducted with mothers at home, providing printed materials and child-friendly activities to support disclosure of their diagnosis.
The primary outcome was disclosure to the child (full, partial, none). The secondary outcomes included maternal mental health (General Health Questionnaire) and child mental health (Child Behaviour Checklist).
One hundred and seventy-one (60%) women 'fully' disclosed and 110 (40%) women 'partially' disclosed their HIV status to their child. Women who perceived their health to be excellent were less likely to 'fully' disclose compared to those considering their health to be poorer [adjusted odds ratio 0.50 (0.26-0.98), P = 0.042]. [corrected]. Compared to those not in a current partnership, those with a current partner were almost three times more likely to 'fully' disclose [adjusted odds ratio 2.92 (1.33-6.40), P = 0.008]. Mothers reported that most children reacted calmly to 'full' (79%) or 'partial' disclosure (83%). Compared to 'partial' disclosure, 'full' disclosure was associated with more children asking questions about maternal death (18 versus 8%).
This intervention is acceptable in resource-limited settings and shows promise. Further research using a controlled design is needed to test this intervention.
撒哈拉以南非洲地区有大量感染艾滋病毒的父母，他们需要得到支持来抚养未感染艾滋病毒的子女。本研究评估了“阿玛古古干预措施”，该措施旨在帮助母亲们向未感染艾滋病毒的子女透露自己的艾滋病毒诊断情况。
干预前后的无对照评估。
南非卫生与人口研究中心。
281名感染艾滋病毒的妇女及其6至10岁未感染艾滋病毒的子女。
这项由非专业顾问主导的干预措施包括在家中与母亲们进行六次会面，提供印刷材料和适合儿童的活动，以支持她们透露自己的诊断情况。
主要结果是向孩子透露情况（完全透露、部分透露、未透露）。次要结果包括母亲的心理健康（一般健康问卷）和孩子的心理健康（儿童行为检查表）。
171名（60%）妇女“完全”透露了情况，110名（40%）妇女“部分”向孩子透露了自己的艾滋病毒感染状况。认为自己健康状况极佳的妇女与认为自己健康状况较差的妇女相比，“完全”透露情况的可能性较小[调整后的优势比为0.50（0.26 - 0.98），P = 0.042]。[已校正]。与目前没有伴侣的妇女相比，有现任伴侣的妇女“完全”透露情况的可能性几乎是前者的三倍[调整后的优势比为2.92（1.33 - 6.40），P = 0.008]。母亲们报告说，大多数孩子对“完全”透露（79%）或“部分”透露（83%）的反应较为平静。与“部分”透露相比，“完全”透露与更多孩子询问母亲死亡问题相关（18%对8%）。
在资源有限的环境中，这种干预措施是可以接受的，并且显示出了前景。需要采用对照设计进行进一步研究来检验这种干预措施。
