Eloff Irma, Finestone Michelle, Makin Jennifer D, Boeving-Allen Alex, Visser Maretha, Ebersöhn Liesel, Ferreira Ronél, Sikkema Kathleen J, Briggs-Gowan Margaret J, Forsyth Brian W C
aFaculty of Education bDepartment of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa cDepartment of Pediatrics, Wake Forest University, Winston-Salem, North Carolina, USA dDepartment of Psychology, University of Pretoria, Pretoria, South Africa eDepartment of Psychology and Neuroscience, and Global Health, Duke University, Durham, North Carolina fDepartment of Psychiatry, University of Connecticut Health Center, Farmington gDepartment of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
AIDS. 2014 Jul;28 Suppl 3(0 3):S347-57. doi: 10.1097/QAD.0000000000000335.
The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers.
DESIGN/METHODS: HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers. Mothers and children were in separate groups for 14 sessions, followed by 10 interactive sessions. The primary focus was on parent-child communication and parenting. Assessments were completed by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses were used to assess change over time.
Of 390 mother-child pairs, 84.6% (I: 161 and S: 169) completed at least two interviews and were included in the analyses. Children's mean age was 8.4 years and 42% of mothers had been ill in the prior 3 months. Attendance in groups was variable: only 45.7% attended more than 16 sessions. Intervention mothers reported significant improvements in children's externalizing behaviours (ß = -2.8, P = 0.002), communication (ß = 4.3, P = 0.025) and daily living skills (ß = 5.9, P = 0.024), although improvement in internalizing behaviours and socialization was not significant (P = 0.061 and 0.052, respectively). Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence.
This is the first study demonstrating benefits of an intervention designed to promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context and has the potential to benefit large numbers of children, if it can be widely implemented.
本研究旨在评估一项旨在增强与感染艾滋病毒的母亲共同生活的幼儿适应力的干预措施的效果。
设计/方法：在南非茨瓦内诊所就诊的艾滋病毒呈阳性的妇女及其6至10岁的子女被随机分为干预组（I）或标准护理组（S）。干预措施包括由社区护理人员主持的每周24次小组会议。母亲和孩子在14次会议中分别分组，随后是10次互动会议。主要重点是亲子沟通和育儿。母亲和孩子在基线以及6、12和18个月时完成评估。采用重复混合线性分析来评估随时间的变化。
在390对母婴中，84.6%（干预组：161对，标准护理组：169对）完成了至少两次访谈并纳入分析。儿童的平均年龄为8.4岁，42%的母亲在过去3个月中患病。小组会议的出席率各不相同：只有45.7%的人参加了超过16次会议。干预组的母亲报告说，孩子的外化行为（β = -2.8，P = 0.002）、沟通能力（β = 4.3，P = 0.025）和日常生活技能（β = 5.9，P = 0.024）有显著改善，尽管内化行为和社交能力的改善不显著（分别为P = 0.061和0.052）。干预组的儿童报告焦虑暂时增加，但未报告抑郁或情商方面的差异。
这是第一项证明旨在增强艾滋病毒呈阳性母亲的幼儿适应力的干预措施有益效果的研究。该干预措施是专门为非洲背景设计的，如果能够广泛实施，有可能使大量儿童受益。
