Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
Front Public Health. 2016 Jun 29;4:138. doi: 10.3389/fpubh.2016.00138. eCollection 2016.
Few evidence-based interventions exist to support parenting and child mental health during the process of caregiver HIV status disclosure in sub-Saharan Africa. A secondary analysis of a randomized-controlled trial was conducted to examine the role of family-based intervention versus usual social work care (care as usual) in supporting HIV status disclosure within families in Rwanda.
Approximately 40 households were randomized to family-based intervention and 40 households to care as usual. Parenting, family unity, and child mental health during the process of disclosure were studied using quantitative and qualitative research methods.
Many of the families had at least one caregiver who had not disclosed their HIV status at baseline. Immediately post-intervention, children reported lower parenting and family unity scores compared with those in the usual-care group. These changes resolved at 3-month follow-up. Qualitative reports from clinical counselor intervention sessions described supported parenting during disclosure. Overall findings suggest adjustments in parenting, family unity, and trust surrounding the disclosure process.
Family-based intervention may support parenting and promote child mental health during adjustment to caregiver HIV status disclosure. Further investigation is required to examine the role of family-based intervention in supporting parenting and promoting child mental health in HIV status disclosure.
在撒哈拉以南非洲，针对照顾者 HIV 状况披露过程中育儿和儿童心理健康的循证干预措施很少。对一项随机对照试验的二次分析旨在研究家庭为基础的干预与常规社会福利工作护理（常规护理）在支持卢旺达家庭内 HIV 状况披露方面的作用。
大约 40 个家庭被随机分配到家庭为基础的干预组，40 个家庭被分配到常规护理组。使用定量和定性研究方法研究了披露过程中的育儿、家庭团结和儿童心理健康。
许多家庭至少有一名照顾者在基线时没有透露其 HIV 状况。干预后立即，与常规护理组相比，儿童报告的育儿和家庭团结得分较低。这些变化在 3 个月随访时得到解决。来自临床顾问干预会议的定性报告描述了在披露过程中支持育儿。总体研究结果表明，在照顾者 HIV 状况披露过程中，育儿、家庭团结和信任方面存在调整。
家庭为基础的干预可能会支持育儿，并促进儿童心理健康，以适应照顾者 HIV 状况的披露。需要进一步研究家庭为基础的干预在支持育儿和促进 HIV 状况披露中儿童心理健康方面的作用。
