Becker Elisabeth, Kuo Caroline, Operario Don, Moshabela Mosa, Cluver Lucie
Division of Community, Family Health and Equity, Rhode Island Department of Health, Providence, Rhode Island, USA.
Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
Sex Transm Infect. 2015 Nov;91(7):528-33. doi: 10.1136/sextrans-2014-051728. Epub 2015 Jan 13.
This study assessed children's awareness for adult HIV-associated symptoms and illnesses using a verbal assessment tool by analysing inter-rater reliability between adult-child dyads. This study also evaluated sociodemographic and household characteristics associated with child awareness of adult symptomatic HIV.
A cross-sectional survey using a representative community sample of adult-child dyads (N=2477 dyads) was conducted in KwaZulu-Natal, South Africa. Analyses focused on a subsample (n=673 adult-child dyads) who completed verbal assessment interviews for symptomatic HIV. We used an existing validated verbal autopsy approach, originally designed to determine AIDS-related deaths by adult proxy reporters. We adapted this approach for use by child proxy reporters for reporting on HIV-associated symptoms and illnesses among living adults. Analyses assessed whether children could reliably report on adult HIV-associated symptoms and illnesses and adult provisional HIV status.
Adult-child pairs concurred above the 65th percentile for 9 of the 10 HIV-associated symptoms and illnesses with sensitivities ranging from 10% to 100% and specificities ranging from 20% to 100%. Concordant reporting between adult-child dyads for the adult's provisional HIV status was 72% (sensitivity=68%, specificity=73%). Children were more likely to reliably match adult's reports of provisional HIV status when they lived in households with more household members, and households with more robust socioeconomic indicators including access to potable water, food security and television.
Children demonstrate awareness of HIV-associated symptoms and illnesses experienced by adults in their household. Children in households with greater socioeconomic resources and more household members were more likely to reliably report on the adult's provisional HIV status.
本研究通过分析成人与儿童二元组之间的评分者间信度，使用一种言语评估工具评估儿童对成人艾滋病毒相关症状和疾病的认知。本研究还评估了与儿童对成人有症状艾滋病毒认知相关的社会人口学和家庭特征。
在南非夸祖鲁 - 纳塔尔省对成人与儿童二元组的代表性社区样本（N = 2477个二元组）进行了横断面调查。分析集中在一个子样本（n = 673个成人与儿童二元组）上，这些二元组完成了关于有症状艾滋病毒的言语评估访谈。我们使用了一种现有的经过验证的言语尸检方法，该方法最初旨在由成人代理报告者确定与艾滋病相关的死亡情况。我们对这种方法进行了调整，以供儿童代理报告者用于报告在世成年人中与艾滋病毒相关的症状和疾病。分析评估了儿童是否能够可靠地报告成人艾滋病毒相关症状和疾病以及成人的临时艾滋病毒状态。
成人与儿童对10种艾滋病毒相关症状和疾病中的9种达成一致的比例高于第65百分位数，敏感度范围为10%至100%，特异度范围为20%至100%。成人与儿童二元组对成人临时艾滋病毒状态的一致报告率为72%（敏感度 = 68%，特异度 = 73%）。当儿童生活在家庭成员较多的家庭以及社会经济指标更强的家庭中，包括能够获得饮用水、食品安全和电视时，他们更有可能可靠地匹配成人关于临时艾滋病毒状态的报告。
儿童表现出对其家庭中成人经历的艾滋病毒相关症状和疾病的认知。社会经济资源更丰富且家庭成员更多的家庭中的儿童更有可能可靠地报告成人的临时艾滋病毒状态。
