Das Aritra, Detels Roger, Afifi Abdelmonem A, Javanbakht Marjan, Sorvillo Frank J, Panda Samiran
CARE India Solutions for Sustainable Development, H No. 14, Patliputra Colony, Patna, Bihar, 800013, India.
Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, 90095-1772, USA.
Qual Life Res. 2017 Aug;26(8):2171-2180. doi: 10.1007/s11136-017-1557-x. Epub 2017 Mar 25.
Helping children living with HIV (CLH) to attain an optimum quality of life is an important goal for HIV programs around the world. Our principal objectives were to determine the association of HIV infection with different domains of health-related quality of life (HRQoL) among 8- to 15-year-old CLH in India and to compare the HRQoL parameters between CLH and HIV-negative children born to HIV-infected parents ("HIV-affected"). We also assessed whether antiretroviral therapy (ART) and CD4 lymphocyte counts were associated with HRQoL among CLH.
Using the "Quality of Life (health-related) of Children Living with HIV/AIDS in India" instrument, we interviewed 199 CLH and 194 HIV-affected children from three districts of West Bengal, India. Participants were asked to quantify the difficulties faced by them in six HRQoL domains: physical, emotional, social, school functioning, symptoms, and discrimination.
The mean age of the participants was 11.6 (SD ± 2.5) years. CLH, compared to HIV-affected children, had poorer scores on all HRQoL domains except 'discrimination.' Among CLH, there were no significant differences in HRQoL domain scores (except in the 'discrimination' domain) between ART-treated and -untreated groups. CD4 lymphocyte count was found to be a significant positive predictor of the 'symptom' scale score.
In India, interventions for CLH mostly focus on biological disease. However, the current study revealed that HRQoL among CLH was much poorer than that of a socio-demographically comparable group. Culturally and developmentally appropriate psychosocial support measures for Indian CLH are urgently needed.
帮助感染艾滋病毒的儿童(CLH)获得最佳生活质量是全球艾滋病项目的一项重要目标。我们的主要目的是确定印度8至15岁的CLH中艾滋病毒感染与健康相关生活质量(HRQoL)不同领域之间的关联,并比较CLH与感染艾滋病毒父母所生的艾滋病毒阴性儿童(“受艾滋病影响者”)的HRQoL参数。我们还评估了抗逆转录病毒疗法(ART)和CD4淋巴细胞计数是否与CLH的HRQoL相关。
我们使用“印度感染艾滋病毒/艾滋病儿童的(与健康相关的)生活质量”工具,对来自印度西孟加拉邦三个地区的199名CLH和194名受艾滋病影响的儿童进行了访谈。参与者被要求对他们在六个HRQoL领域所面临的困难进行量化:身体、情感、社会、学校功能、症状和歧视。
参与者的平均年龄为11.6(标准差±2.5)岁。与受艾滋病影响的儿童相比,CLH在除“歧视”之外的所有HRQoL领域得分更低。在CLH中,接受ART治疗和未接受治疗的组之间在HRQoL领域得分(“歧视”领域除外)没有显著差异。发现CD4淋巴细胞计数是“症状”量表得分的显著正向预测因子。
在印度,针对CLH的干预措施大多集中在生物疾病方面。然而,当前研究表明,CLH的HRQoL比社会人口统计学上可比的群体差得多。迫切需要为印度的CLH提供符合文化和发展需求的心理社会支持措施。