HIV-Associated orphanhood and children's psychosocial distress: Theoretical framework tested with data from Zimbabwe
HIV-Associated orphanhood and children's psychosocial distress: Theoretical framework tested with data from Zimbabwe
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DOI：
10.2105/ajph.2007.116038
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发表时间：
2008-01-01
影响因子：
12.7
通讯作者：
Jukes, Matthew C. H.
中科院分区：
文献类型：
--
作者：
Nyamukapa, Constance A.;Gregson, Simon;Jukes, Matthew C. H.
目标。我们测量了撒哈拉以南非洲人口中孤儿的心理社会影响，并评估了一个新的框架，以了解孤儿和其他弱势儿童心理社会困境的原因和后果。对该框架进行了评估，使用了2004年津巴布韦全国调查中采访的5321名12至17岁儿童的数据。我们使用主成分分析构建了心理社会苦恼的测量方法。我们使用回归分析来获得心理社会苦恼的标准化参数估计和早期性行为的优势比。孤儿比非孤儿有更多的心理社会困扰。无论男女，父亲、母亲和双亲孤儿都表现出比非孤儿、非弱势儿童更严重的痛苦。在我们控制了更接近的决定因素的差异后，孤儿仍然与心理社会痛苦有关。母亲和父亲的孤儿比非孤儿、非易受伤害的儿童更有可能发生性行为。在我们控制了心理社会痛苦之后，这些差异被缩小了。津巴布韦的孤儿青少年比非孤儿、不脆弱的儿童遭受更大的心理社会痛苦，这可能导致提前发生性行为和感染艾滋病毒的可能性增加。应科学地评估提供心理社会支持的战略的效果。
Objectives. We measured the psychosocial effect of orphanhood in a sub-Saharan African population and evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children.Methods. The framework was evaluated using data from 5321 children aged 12 to 17 years who were interviewed in a 2004 national survey in Zimbabwe. We constructed a measure of psychosocial distress using principle components analysis. We used regression analyses to obtain standardized parameter estimates of psychosocial distress and odds ratios of early sexual activity.Results. Orphans had more psychosocial distress than did nonorphans. For both genders, paternal, maternal, and double orphans exhibited more-severe distress than did nonorphaned, nonvulnerable children. Orphanhood remained associated with psychosocial distress after we controlled for differences in more-proximate determinants. Maternal and paternal orphans were significantly more likely than were nonorphaned, nonvulnerable children to have engaged in sexual activity. These differences were reduced after we controlled for psychosocial distress.Conclusions. Orphaned adolescents in Zimbabwe suffer greater psychosocial distress than do nonorphaned, nonvulnerable children, which may lead to increased likelihood of early onset of sexual intercourse and HIV infection. The effect of strategies to provide psychosocial support should be evaluated scientifically.