Manopaiboon C, Shaffer N, Clark L, Bhadrakom C, Siriwasin W, Chearskul S, Suteewan W, Kaewkungwal J, Bennetts A, Mastro T D
The HIV/AIDS Collaboration, Nonthaburi, Thailand.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 May 1;18(1):54-63. doi: 10.1097/00042560-199805010-00009.
The objective of this study was to assess changes in the family situation of HIV-infected women who have recently given birth. As part of a prospective perinatal HIV transmission study, interviews were conducted with a subset of HIV-infected women at 18 to 24 months postpartum, and answers were compared with baseline information obtained during pregnancy. Standardized scales were used to assess levels of psychosocial functioning. A convenience sample of 129 HIV-infected women enrolled during pregnancy was interviewed at 18 to 24 months postpartum. At delivery, the women were young (median age, 22 years), primiparous (57%), and asymptomatic (93%). When baseline and follow-up data were compared, more women were living alone (1% versus 6%; p = 0.03), fewer women were living with their partners (98% versus 73%; p < 0.001), and 30% of families had reduced incomes. At follow-up, 10% of partners had died, and more partners than wives had become ill or died (21% versus 4%; p = 0.02). Most children (78%) were living with their mothers, but only 57% of the HIV-infected women were the primary caretakers. Fewer women had disclosed their HIV status to others (e.g., family, friends) than to their partners (34% versus 84%; p < 0.001), largely because of fear of disclosure. The women appeared to have high levels of depression and worry. The women's greatest worries were about their children's health and the family's future. Within 2 years after childbirth, substantial change within the families of HIV-infected women was evident. These were manifest by partner illness or death, family separation, reduced family income, shifting responsibilities for child care, and signs of depression and isolation. Providing family support is a major challenge in Thailand as the perinatal HIV epidemic progresses.
本研究的目的是评估近期分娩的感染艾滋病毒妇女的家庭状况变化。作为一项前瞻性围产期艾滋病毒传播研究的一部分，在产后18至24个月对一部分感染艾滋病毒的妇女进行了访谈，并将答案与孕期获得的基线信息进行比较。使用标准化量表评估心理社会功能水平。对孕期登记的129名感染艾滋病毒妇女的便利样本在产后18至24个月进行了访谈。分娩时，这些妇女很年轻（中位年龄22岁），初产（57%），且无症状（93%）。比较基线和随访数据时，独居的妇女更多（1%对6%；p = 0.03），与伴侣同住的妇女更少（98%对73%；p < 0.001），30%的家庭收入减少。随访时，10%的伴侣死亡，患病或死亡的伴侣比妻子更多（21%对4%；p = 0.02）。大多数儿童（78%）与母亲同住，但只有57%的感染艾滋病毒妇女是主要照顾者。向他人（如家人、朋友）披露艾滋病毒感染状况 的妇女比向伴侣披露的更少（34%对84%；p < 0.001），主要是因为害怕披露。这些妇女似乎有较高程度的抑郁和担忧。她们最担心的是孩子的健康和家庭的未来。分娩后两年内，感染艾滋病毒妇女的家庭发生了明显变化。这些变化表现为伴侣患病或死亡、家庭分离、家庭收入减少、育儿责任转移以及抑郁和孤立的迹象。随着围产期艾滋病毒疫情的发展，提供家庭支持在泰国是一项重大挑战。
