Resilience in perinatal HIV+ adolescents in South Africa.
Resilience in perinatal HIV+ adolescents in South Africa.
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DOI：
10.1080/09540121.2016.1176676
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发表时间：
2016-03
期刊：
影响因子：
1.7
通讯作者：
McKay M
中科院分区：
文献类型：
--
作者：
Bhana A;Mellins CA;Small L;Nestadt DF;Leu CS;Petersen I;Machanyangwa S;McKay M
越来越多的围产期感染艾滋病毒（PHIV+）的青年能够更好地获得治疗，存活到成年。然而，很少有研究检验艾滋病毒阳性青年在面对逆境（恢复力）时的积极结果。社会行动理论（SAT）为南非hiv阳性青年的研究提供了理论框架，允许检查影响行为健康的环境、社会和自我调节因素。数据来自青少年和照顾者基线访谈，简单地汇总了VUKA家庭项目的试点（N=66）和更大（N= 111）随机对照试验（RCT）。在这项分析中，结果包括情绪和行为功能（总困难）和亲社会行为。潜在的SAT相关因素包括社会人口统计学；照料者健康和心理健康；亲子关系因素；污名，儿童应对，支持；和自尊。调整了年龄、性别和研究的回归分析显示，在情境、社会和自我调节水平上存在显著关联。较低的儿童总困难得分与较低的照顾者抑郁（β = 3.906,p < .001）、较少的照顾者报告的关于困难问题的沟通（β = 1.882, p = .009）和较高的青少年自尊（β = -0.119, p = .020）相关。更大的亲社会行为与更多的照顾者报告的沟通（β = 0.722, p = 0.020）和儿童使用一厢情愿的应对方式（β = 5.532, p = 0.009）相关。较少的青少年抑郁与较高的照顾者教育（β = - 0.399, p = 0.010）、较高的照顾者监督（β = - 1.261, p = 0.012）、更多的社会支持寻求（β = - 0.453, p = 0.002）、较高的青少年自尊（β = - 0.067, p < 0.001）、较低的内化污名（β = 0.608, p = 0.040）和儿童使用辞职应对（β = 1.152, p = 0.041）相关。我们的数据支持以证据为基础的家庭干预措施，这些干预措施也能促进青少年的自我调节技能，从而增强艾滋病毒阳性青少年的健康和心理健康。
Increasing numbers of perinatally HIV (PHIV+)-infected youth are surviving into adulthood with better access to treatment. However, few studies examine positive outcomes in the face of adversity (resilience) for PHIV+ youth. Social Action Theory (SAT) provided the theoretical framework for this study of PHIV + youth in South Africa (SA), allowing examination of contextual, social, and self-regulatory factors that influence behavioral health. Data were from youth and caregiver baseline interviews, simply pooled from a pilot (N=66) and larger (n=111) randomized control trial (RCT) of the VUKA Family program. For this analysis, outcomes included emotional and behavioral functioning (total difficulties), and prosocial behaviors. Potential SAT correlates included socio-demographics; caregiver health and mental health; parent-child relationship factors; stigma, and child coping, support; and self-esteem. Regression analyses adjusted for age, gender, and study revealed significant associations at the contextual, social, and self-regulation level. Lower total child difficulties scores were associated with lower caregiver depression (β = 3.906,p < .001), less caregiver-reported communication about difficult issues (β = 1.882, p = .009) and higher youth self-esteem (β = -0.119, p = .020). Greater prosocial behaviors were associated with greater caregiver-reported communication (β = 0.722, p = .020) and child use of wishful thinking for coping (β = 5.532, p = .009). Less youth depression was associated with higher caregiver education (β =−0.399, p = .010), greater caregiver supervision (β = −1.261, p = .012), more social support seeking (β = −0.453, p = .002), higher youth self-esteem (β = −0.067, p < .001), lower internalized stigma (β = 0.608, p = .040), and child use of resignation for coping (β = 1.152, p = .041). Our data support evidence-based family interventions that also promote youth self-regulation skills to enhance the health and mental health of PHIV+ youth.