Goodman Michael L, Mutambudzi Miriam S, Gitari Stanley, Keiser Philip H, Seidel Sarah E
a University of Texas Medical Branch , Galveston , TX , USA.
b Sodzo International , Houston , TX , USA.
AIDS Care. 2016 Mar;28 Suppl 2(sup2):168-75. doi: 10.1080/09540121.2016.1176672.
Within Kenya, an estimated quarter of a million children live on the streets, and 1.8 million children are orphaned. In this study, we analyze how HIV contributes to the phenomenon of child-street migration. We interviewed a random community sample of caregiving women (n = 1974) in Meru County, Kenya, using a structured questionnaire in summer 2015. Items included reported HIV prevalence of respondent and her partner, social support, overall health, school enrollment of biologically related children and whether the respondent has a child currently living on the streets. Controlling for alcohol use, education, wealth, age and household size, we found a positive-graded association between the number of partners living with HIV and the probability that a child lives on the street. There was little difference in the odds of a child living on the street between maternally affected and paternally affected households. Lower maternal social support, overall health and school enrollment of biologically related children mediated 14% of the association between HIV-affected households and reporting child-street migration. Street-migration of children is strongly associated with household HIV, but the small percentage of mediated effect presents a greater need to focus on interactions between household and community factors in the context of HIV. Programs and policies responding to these findings will involve targeting parents and children in HIV-affected households, and coordinate care between clinical providers, social service providers and schools.
在肯尼亚，估计有25万儿童流落街头，180万儿童成为孤儿。在本研究中，我们分析了艾滋病毒是如何导致儿童街头流浪现象的。2015年夏天，我们在肯尼亚梅鲁县使用结构化问卷对随机抽取的社区照料女性样本（n = 1974）进行了访谈。调查项目包括受访者及其伴侣的艾滋病毒感染率报告、社会支持、总体健康状况、亲生孩子的入学情况以及受访者是否有孩子目前流落街头。在控制了酒精使用、教育程度、财富、年龄和家庭规模后，我们发现与感染艾滋病毒的伴侣数量与孩子流落街头的可能性之间存在正相关关系。在受母亲影响的家庭和受父亲影响的家庭中，孩子流落街头的几率几乎没有差异。较低的母亲社会支持、总体健康状况以及亲生孩子的入学率介导了受艾滋病毒影响的家庭与报告儿童街头流浪之间14%的关联。儿童街头流浪与家庭艾滋病毒感染密切相关，但介导效应的比例较小，这表明更有必要关注艾滋病毒背景下家庭因素与社区因素之间的相互作用。针对这些研究结果的项目和政策将涉及针对受艾滋病毒影响家庭中的父母和儿童，并协调临床提供者、社会服务提供者和学校之间的照料工作。
