Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model
Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model
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DOI：
10.1016/j.socscimed.2013.03.028
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发表时间：
2013-06-01
影响因子：
5.4
通讯作者：
Nikelo, Joy
中科院分区：
文献类型：
--
作者：
Cluver, Lucie;Orkin, Mark;Nikelo, Joy
越来越多的证据表明，父母感染艾滋病毒/艾滋病和死亡对儿童的心理、健康和发展产生负面影响。然而，很少有人知道父母艾滋病如何导致负面的儿童结果。本研究采用结构方程建模方法，开发了一个基于经验的理论模型，父母或主要照顾者的艾滋病疾病，艾滋病的发病率和预测干预因素与儿童的心理困扰，教育机会和性健康之间的互动关系。2009-2011年，采用分层随机抽样的方法，从南非三个省的6002名10-17岁儿童中收集了横断面数据。对照组包括艾滋病致孤儿童、其他原因致孤儿童和非孤儿儿童，以及父母或主要照顾者患有艾滋病、其他原因或健康状况不佳的儿童。参与者报告了心理症状，教育机会和性健康风险，以及假设的社会人口和干预因素。为了建立一个多个孩子的结果，多元回归和结构方程模型的互动理论模型，为每个单独的结果，然后组合成一个整体模型。无论是艾滋病的童年还是父母的艾滋病与心理困扰、教育机会或性健康都没有直接关系。相反，艾滋病孤儿和父母艾滋病疾病对所有测量结果产生了显着的间接影响。儿童心理、教育和性健康风险有一套共同的干预变量，包括父母残疾、贫困、社区暴力、耻辱和虐待儿童，这些共同构成连锁效应。在所有模型中，父母艾滋病患病比艾滋病患病有更强的影响和更多的风险途径，特别是通过贫困和父母残疾。艾滋病和父母艾滋病通过多种相互关联的途径影响儿童的结果。在这项研究中开发的互动模式建议重点领域的干预措施与艾滋病影响的儿童。(C)2013爱思唯尔有限公司保留所有权利。
Increasing evidence demonstrates negative psychological, health, and developmental outcomes for children associated with parental HIV/AIDS illness and death. However, little is known about how parental AIDS leads to negative child outcomes. This study used a structural equation modelling approach to develop an empirically-based theoretical model of interactive relationships between parental or primary caregiver AIDS-illness, AIDS-orphanhood and predicted intervening factors associated with children's psychological distress, educational access and sexual health. Cross-sectional data were collected in 2009-2011, from 6002 children aged 10-17 years in three provinces of South Africa using stratified random sampling. Comparison groups included children orphaned by AIDS, orphaned by other causes and non-orphans, and children whose parents or primary caregivers were unwell with AIDS, unwell with other causes or healthy. Participants reported on psychological symptoms, educational access, and sexual health risks, as well as hypothesized sociodemographic and intervening factors. In order to build an interactive theoretical model of multiple child outcomes, multivariate regression and structural equation models were developed for each individual outcome, and then combined into an overall model. Neither AIDS-orphanhood nor parental AIDS-illness were directly associated with psychological distress, educational access, or sexual health. Instead, significant indirect effects of AIDS-orphanhood and parental AIDS-illness were obtained on all measured outcomes. Child psychological, educational and sexual health risks share a common set of intervening variables including parental disability, poverty, community violence, stigma, and child abuse that together comprise chain effects. In all models, parental AIDS-illness had stronger effects and more risk pathways than AIDS-orphanhood, especially via poverty and parental disability. AIDS-orphanhood and parental AIDS-illness impact child outcomes through multiple, interlinked pathways. The interactive model developed in this study suggests key areas of focus for interventions with AIDS-affected children. (C) 2013 Elsevier Ltd. All rights reserved.