艾滋病对中国儿童影响的研究

目的了解和认识艾滋病对中国儿童的影响。方法利用方差分析等方法,提出一个多层次的分析框架,设计以儿童成长为核心的家庭调查表及儿童访谈提纲,并进行实地调查。结果受艾滋病影响儿童的家庭人均生产收入减少;救助活动对改善艾滋病孤儿家庭的经济状况起到了一定的作用;父母存活的受艾滋病影响儿童的缺课率最高;受艾滋病影响儿童感受到心理压力和忧伤。结论艾滋病对儿童的影响主要反映在儿童的生活环境、生存状况和身心健康三个层面。在这三个层面,受艾滋病影响儿童与非艾滋病家庭的儿童存在明显的差异。     

云南某县艾滋病及其他脆弱家庭中儿童身心健康现况调查

目的了解中国政府／联合国儿童基金会艾滋病预防关怀项目县艾滋病及其他脆弱家庭中心儿童的身心健康现况,为项目提供基线资料。方法通过随机抽样,在云南省某项目县选取250名0-17岁来自受艾滋病、吸毒和贫困影响家庭的儿童,测量身高,并对其中154名6岁以上儿童进行心理问卷调查。结果来自三种家庭的儿童的身高没有显著性差异,心理状况有显著性差异。近68％的受艾滋病影响儿童不能处理生活中的困难,对生活中的事也不能决定怎么办;58％的受艾滋病影响的儿童害怕别人不和他（她）玩;67％的受艾滋病影响的儿童比较自信,但仍低于受吸毒影响的儿童（89％）。结论受艾滋病影响家庭的儿童与其他脆弱家庭儿童的心理状况不同,社区关怀项目应考虑之间的区别。     

云南农村少数民族地区艾滋病对家庭影响的研究

目的通过调查农村少数民族地区艾滋病病毒(HIV)感染者家庭和非HIV感染者家庭的家庭规模、经济状况和医疗负担等,了解艾滋病在云南省少数民族地区对家庭造成的社会经济影响。方法采用对照的方法,首先整群随机抽取HIV/艾滋病(AIDS)病人家庭,然后按2∶1的比例选取吸毒非感染者家庭和一般家庭。结果调查发现,HIV感染者家庭目前家庭规模显著小于一般家庭(P<0.01);HIV感染者家庭年均收入较低,而年均支出没有统计学意义;HIV感染者家庭的医疗负担要显著高于对照组家庭。结论艾滋病对家庭造成的最直接的影响在于削弱劳动力、减少家庭收入、增加医疗负担,进而破坏家庭规模和结构,导致家庭社会功能的丧失和经济贫困。     

艾滋病与艾滋病家庭研究进展

艾滋病影响的不仅仅是艾滋病病人本人,而是整个家庭以及家庭系统,而家庭在病人应对生理和心理压力的过程中起到了重要的支持性作用。文章从艾滋病对家庭及家庭系统的影响,家庭对艾滋病病人的影响,以及艾滋病家庭的压力应对三个方面回顾和总结了艾滋病家庭的相关研究。国家政府以及相关研究者可以关注作为整体的艾滋病家庭,丰富艾滋病家庭压力的应对方式,从而提高艾滋病家庭的生活水平,维护社会和谐。     

受艾滋病影响儿童关爱救助政策落实情况的实证分析

目的分析受艾滋病影响儿童相关政策的落实情况。方法采用问卷调查、个案访谈、深入访谈等方法,获得我国艾滋病流行较为严重的四个省份的相关数据,通过定量、定性分析相结合的方法分析。结果共得到有效抚养人问卷149份,涉及受艾滋病影响儿童323名;有效多部门工作人员问卷23份,多部门深入访谈35次。其中县/市级深入访谈30次(含多部门研讨会7次),省级深入访谈5次(含多部门研讨会3次)。调查家庭中有57.7%的家庭儿童获得了生活救助,20.1%的家庭儿童获得了教育救助,5.4%的家庭儿童获得了医疗救助,17.6%的家庭儿童参加过心理关怀活动。但现有政策在执行过程中,仍面临缺乏资金和人员等保障条件、信息收集和共享困难等问题。结论国家及地方都出台了一系列针对受艾滋病影响儿童的关怀救助政策,为减轻艾滋病对儿童的影响发挥了积极作用,但政策落实尚不均衡,阻碍政策有效实施的因素仍然存在。     

艾滋病病毒暴露前预防用药依从性研究进展

艾滋病病毒PrEP是在发生高危行为之前服用特定抗病毒药物预防HIV感染的方法,PrEP的有效性主要取决于服药者的依从性。本文综述了PrEP用药依从性及影响因素研究进展,服药人群中依从的人数占比在14.3%～74%左右,总体依从率约为23%～66%。PrEP用药依从性受忘记服药和忘记带药、污名化、自我感知HIV感染风险、经济支持、医保和服务水平、家庭和同伴的支持等因素影响,可针对这些因素制定实施干预策略,以有效提高服药者依从性。     

50岁及以上人群对艾滋病歧视现状及其影响因素研究

目的 探索50岁及以上人群对艾滋病歧视现状及相关影响因素。方法 本文为横断面研究,于2022年10-12月,采用分层整群抽样法抽取湖南省五个区域的人群（≥50岁）进行问卷调查,采用的问卷工具为一般资料调查表、艾滋病知识问卷、艾滋病歧视量表。使用SPSS 25.0统计软件对数据进行统计,采用t检验和多元线性回归分析艾滋病歧视的影响因素。结果 最终收取有效问卷959份,调查结果显示50岁及以上人群的艾滋病知识知晓率为39.52%,艾滋病歧视平均得分为（3.56±0.61）分,知晓艾滋病知识的人群的艾滋病歧视水平明显低于不知晓艾滋病知识的人群,且差异有统计学意义（P<0.01）,多元线性回归结果表明,男性、文化程度较低、居住地经济水平低、与家人伴侣居住、月收入较低以及不知晓艾滋病知识都能导致艾滋病歧视水平升高（P<0.05）。结论 居住地区、受教育程度、性别及其收入情况都是影响50岁及以上人群对艾滋病歧视的关键因素。应重点针对男性、经济不发达地区、低学历、低收入、不知晓艾滋病知识的50岁及以上人群开展易于接受的反艾滋病歧视宣传,有效降低艾滋病歧视水平。     

艾滋病高危人群对暴露后预防使用意愿的影响因素研究

目的利用三种分类算法分析艾滋病高危人群对暴露后预防(PEP)使用意愿的影响因素,并进行预测及预测效果评价。方法采用方便抽样,在中国11个城市招募五类艾滋病高危人群2 002人,通过电子问卷收集相关信息,利用Logistic回归、决策树和随机森林分析PEP使用意愿的影响因素,并对验证集进行预测,比较三者的预测性能。结果在五类高危人群中,MSM的PEP使用意愿最高,为82.6%,暗娼的PEP使用意愿最低,为42.8%。Logistic回归结果显示,与MSM相比,吸毒人群(OR=0.472,95%CI:0.306～0.723)和暗娼(OR=0.497,95%CI:0.306～0.804)的PEP使用意愿较低,此外,受教育程度低、艾滋病风险认知高、PEP认知水平低、饮酒、近1个月未发生无套性行为、近1年寻求过艾滋病咨询服务者对PEP的使用意愿较低(P 0.05)。决策树模型结果显示PEP认知、受教育程度、艾滋病风险认知和人群类别是影响PEP使用意愿的主要因素。随机森林结果显示PEP使用意愿的主要影响因素按重要性排序依次为人群类别、PEP认知、艾滋病风险认知和受教育程度。三种分类算法均较好地预测了PEP使用意愿,Logistic回归、决策树和随机森林的预测准确率分别为0.763、0.743和0.810,随机森林的预测效果最佳。结论三种分类算法在预测艾滋病高危人群对PEP使用意愿上表现出较好的准确性。应加强艾滋病高危人群的健康教育,尤其是吸毒人群和暗娼,提高对PEP的认知水平,将有助于PEP使用。     

羁押场所HIV感染罪犯集中管理与分散管理的利弊

羁押场所艾滋病的防治工作,对社会艾滋病防治整体成效有着重要的影响作用.通过对监管场所艾滋病病毒(HIV)感染者集中管理与分散管理中的人文关怀,和预防控制艾滋病在高危人群中传播蔓延的利弊进行分析,从而提出实施集中管理的必要性,也提出了当前在集中管理中面临的一些难点与对策.     

艾滋病流行对中国社会及经济的影响

目前,艾滋病流行已成为影响人类社会发展和经济发展最重要的难题之一.在艾滋病流行严重的地区和国家(人口数在100万以上,成人艾滋病患病率在2%以上),艾滋病流行的社会经济危害已得到证实.世界银行在亚撒哈拉非洲部分国家进行的艾滋病流行对社会经济影响的研究表明,艾滋病作为一种恶性传播性疾病,主要感染15～49岁年龄段人口,他们既是创造社会财富的主要劳动人口,同时也是家庭结构的经济和精神支柱.如果流行得不到及时、有效地控制,将会给国家和人民带来严重的灾难,如人均     

Microcredit for people affected by HIV and AIDS: Insights from Kenya

Consequences of HIV and AIDS are exponential in Kenya, touching not only the health of those infected, but also depleting socioeconomic resources of entire families. Access to financial services is one of the important ways to protect and build economic resources. Unfortunately, the norm of financial viability discourages microfinance institutions from targeting people severely impacted by HIV and AIDS. Thus, HIV and AIDS service NGOs have been increasingly getting involved in microcredit activity in recent years for economic empowerment of their clients. Despite limited human resources and funding in the area of microcredit activity, these NGOs have demonstrated that nearly 50% of their microcredit beneficiaries invested money in income-generating activities, resulting in enhancement to their livelihood security. In the short term these NGOs need to improve their current practices. However, this does not mean launching microfinance initiatives within their AIDS-focused programmes, as financial services are best provided by specialised institutions. Longer-term cooperation between microfinance institutions and other AIDS service organisations and donors is necessary to muster appropriate and rapid responses in areas experiencing severe impacts of HIV and AIDS.     

Understanding and mitigating HIV-related resource-based stigma in the era of antiretroviral therapy

The perception in low-resource settings that investment of resources in people living with HIV (PLHIV) is wasted because AIDS is both an incurable and deadly disease is known as resource-based stigma. In this paper, we draw on in-depth interviews (IDI), focus group discussions (FGD), and key informant interviews (KII) with 77 HIV-positive microfinance participants and nongovernmental organization leaders to examine resource-based stigma in the context of increased access to antiretroviral therapy (ART) at an individual, household, and community level in Côte d'Ivoire. The purpose of this exploratory paper is to examine: (1) resource-based stigmatization in the era of ART and (2) the relationship among microfinance, a poverty-reduction intervention, and HIV stigmatization. The frequency with which resource-based stigma was discussed by respondents suggests that it is an important component of HIV-related stigma in this setting. It affected PLHIV's access to material as well as social resources, leading to economic discrimination and social devaluation. Participation in village savings and loans groups, however, mitigated resource-based HIV stigma, suggesting that in the era of increased access to antiretroviral therapy, economic programs should be considered as one possible HIV stigma-reduction intervention.     

The Role of a Microfinance Program on HIV Risk Behavior Among Haitian Women

Microfinance loans targeted at vulnerable female populations have the potential to foster female economic independence, possibly leading to the negotiation of safer sexual practices and reduced HIV risk. This study assessed the relationship between experience with microfinance loans and HIV risk behavior among 192 female clients of the Haitian microfinance organization Fonkoze. Clients with longer microfinance experience were generally found to have lower indicators of HIV risk behavior and higher indicators of relationship power compared to those with shorter experience. In particular, those with longer memberships were 72% less likely to report partner infidelity, were 3.95 times more likely to use condoms with an unfaithful partner, and had higher average general power index scores compared to those with shorter experience. This study provides evidence that long-term exposure to microfinance is associated with reduced HIV risk behavior in Haitian women and that this reduction may be partly regulated by influencing relationship power. These results suggest the need to further explore the use of microfinance as a tool to prevent the spread of HIV.     

Matching Social Support to Individual Needs: A Community-Based Intervention to Improve HIV Treatment Adherence in a Resource-Poor Setting

From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in Lima, Peru to receive community-based accompaniment with supervised antiretrovirals (CASA), consisting of 12 months of DOT-HAART, as well as microfinance assistance and/or psychosocial support group according to individuals?? need. We matched 60 controls from a neighboring district, and assessed final clinical and psychosocial outcomes at 24 months. CASA support was associated with higher rates of virologic suppression and lower mortality. A comprehensive, tailored adherence intervention in the form of community-based DOT-HAART and matched economic and psychosocial support is both feasible and effective for certain individuals in resource-poor settings.     

HIV/AIDS and family support systems: A situation analysis of people living with HIV/AIDS in Lagos State

Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family. The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families. The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state, while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey, among people living with HIV/AIDS, 66% of females and males were in the age group 21–40 years, while 10% were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents, grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children. They are often forced to work more than they would have, or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus, while their children have had to drop out of school, since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment, in order to reduce the impact of the disease on the family.     

The role of social support on resilience,posttraumatic growth,hopelessness, and depression among children of HIV-infected parents in mainland China

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has a profound impact not only on the infected individuals, but also on their families. Children of the HIV-infected parents are particularly affected. The present study examined the relationship between social support, resilience, posttraumatic growth (PTG), hopelessness, and depression among 195 children of HIV-infected parents in mainland China. Results showed that 35.4% of the sample scored above the cutoff of the Children's Depression Inventory. Results from structural equation modeling reported that social support had a significant positive relationship with resilience and PTG. Higher levels of resilience and PTG were associated with lower level of hopelessness which in turn, was associated with lower level of depression. The overall model achieved satisfactory fit. Interventions are needed to improve social support of the children affected by HIV so as to improve their mental health.     

Microfinance and HIV/AIDS Prevention: Assessing its Promise and Limitations

Researchers increasingly argue that poverty and gender inequality exacerbate the spread of HIV/AIDS and that economic empowerment can therefore assist in the prevention and mitigation of the disease, particularly for women. This paper critically evaluates such claims. First, we examine the promises and limits of integrated HIV/AIDS prevention and microfinance programs by examining the available evidence base. We then propose future research agendas and next steps that may help to clear current ambiguities about the potential for economic programs to contribute to HIV/AIDS risk reduction efforts.     

Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti

The present study aims to: (1) estimate the levels of internalizing symptoms and externalizing behaviors among youth affected by HIV in central Haiti; and (2) examine the risk and protective factors associated with these outcomes to identify potential areas of intervention for HIV-affected youth. Baseline data for 492 youth affected by HIV (ages 10–17) and their 330 caregivers were collected for a pilot study of a psychosocial support intervention. Participants were recruited from a list of HIV-positive patients receiving care at Partners In Health/Zanmi Lasante clinic sites. Internalizing and externalizing behaviors were assessed using the Strengths and Difficulties Questionnaire. Demographic, economic, and social indicators were collected using a structured questionnaire administered by trained social workers. Youth affected by HIV in central Haiti displayed high levels of internalizing and, to a lesser degree, externalizing symptoms. Multivariate regression analysis demonstrated risk factors most strongly associated with internalizing symptoms (socioeconomic status, parental depressive symptoms) and externalizing behaviors (household living arrangements, such as living with a stepparent). Social support had a protective effect on externalizing behaviors for both caregiver (β = –0.03, p = 0.01) and self-report (β = –0.05, p < 0.0001). High levels of psychological distress were observed in this population, especially with respect to internalizing outcomes. Interventions should address the economic security, mental health, and access to antiretroviral therapy for families affected by HIV, as well as emphasize the importance of building supportive caregiver–child relationships to decrease the psychological symptoms and impact of other life stressors experienced by youth affected by HIV in Haiti and similar resource-limited settings.     

Population migration and the spread of types 1 and 2 human immunodeficiency viruses.

Over 14 million people are estimated to be infected with the human immunodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migration of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business purposes, and the drug trade. In sub-Saharan Africa, between 1960 and 1980, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The result was a massive migration of rural inhabitants to urban centers concomitant with the spread of HIV-1 to large population centers. With the associated demographic, economic, and social changes, an epidemic of sexually transmitted diseases and HIV-1 was ignited. Migratory patterns were also responsible for the spread of endemic HIV-2 to neighboring West African countries and eventually to Europe, the Americans, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to population density and inherent risk behaviors. Thus, the migration of poor, rural, and young sexually active individuals to urban centers coupled with large international movements of HIV-infected individuals played a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasing the population at risk through increased urban migration, disruption of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled.     

Families living with HIV

Given the historical emergence of the AIDS epidemic first among gay men in the developed world, HIV interventions have primarily focused on individuals rather than families. Typically not part of traditional family structures, HIV-positive gay men in Europe and the US lived primarily in societies providing essential infrastructure for survival needs that highly value individual justice and freedom. Interventions were thus designed to focus on at-risk individuals with programmes that were age and gender segregated. As the epidemic has unfolded, the early focus on individuals has become inadequate: families live with HIV, not just individuals. Families' structure, economy, migration patterns, and developmental life cycles are affected by HIV, and these changes radiate throughout the community creating parallel stresses. Family-based, intergenerational models of detection, prevention and treatment services offer enhanced opportunities for effective interventions and suggest very different intervention settings and strategies. However, these models also require addressing the family's basic needs for survival and security in order to be successfully implemented and sustained over time. As HIV was an opportunity for marginalized persons in the developed world to 'turn their life around', the strengths of families in the developing world may be mobilized to contribute to the community's long-term health, survival and security needs.