Economic causes and effects of AIDS in South African households
Economic causes and effects of AIDS in South African households
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DOI：
10.1097/01.aids.0000244205.03382.84
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发表时间：
2006-09-11
期刊：
影响因子：
3.8
通讯作者：
Booysen, Frikkie L. R.
中科院分区：
文献类型：
--
作者：
Bachmann, Max O.;Booysen, Frikkie L. R.
目的：研究受艾滋病毒/艾滋病影响的家庭中疾病和死亡以及收入和支出之间的关联的程度和时间方向性。设计和受试者：在405个家庭中进行了重复测量的队列研究（1913名居住者），已知有感染艾滋病毒的居住者及其邻居，在南非的一个农村和一个城市地区。成人每月等值收入和支出。艾滋病毒/艾滋病、肺结核和肺炎导致的疾病和死亡情况：在基线时对户主进行访谈调查，每半年再进行五次，提供关于家庭经济、疾病和死亡情况的信息。回归分析采用边际结构模型和“前后”模型来分析变化。根据模型，目前或以前的艾滋病与34% [95%置信区间（CI）23-43%]的月支出降低独立相关，目前或最近的贫困与艾滋病死亡几率高1.74倍（95% CI 0.94-3.2）相关。在前后模型中，每例艾滋病死亡与23%的（95% CI 11-34%）3年内支出下降幅度较大，基线时每月支出增加100美元与0.31（95% CI 0.13-0.74）是艾滋病死亡人数的0.41倍，（95%CI 0.27-0.64）是3年内艾滋病发病次数的两倍。艾滋病死亡和疾病预示着支出下降，贫困预示着艾滋病，这表明福利和有效治疗都是必要的。(c)2006年利平科特威廉姆斯&威尔金斯。
Objective: To investigate the magnitude and temporal directionality of associations between illness and death, and income and expenditure, in households affected by HIV/AIDS.Design and subjects: A cohort study with repeated measures carried out in 405 households (1913 occupants), known to have HIV-infected occupants and their neighbours, in one rural and one urban area of South Africa.Main outcome measures: Monthly adult equivalent income and expenditure. Illness episodes and deaths attributed to HIV/AIDS, tuberculosis and pneumonia.Methods: Interview surveys of household heads were conducted at baseline and five more times, biannually, providing information on household economics, illnesses and deaths. Regression analyses used marginal structural models and 'before-after' models to analyse changes.Results: In marginal structural. models, current or previous AIDS illness was independently associated with 34% [95% confidence intervals (CI) 23-43%] lower monthly expenditure, and current or recent poverty was associated with 1.74 (95% CI 0.94-3.2) times higher odds of an AIDS death. In before-after models, each AIDS death was independently associated with a 23% (95% CI 11-34%) greater expenditure decline over 3 years, and a US$100 higher monthly expenditure at baseline was associated with 0.31 (95% CI 0.13-0.74) times as many AIDS deaths and with 0.41 (95% CI 0.27-0.64) times as many AIDS illness episodes over 3 years.Conclusion: AIDS deaths and illnesses predicted declining expenditure and poverty predicted AIDS, suggesting that both welfare and effective treatment are needed. (c) 2006 Lippincott Williams & Wilkins.