居家艾滋病致孤及脆弱儿童关怀支持项目结果分析

目的评价卧龙区第三轮全球基金艾滋病项目中,居家艾滋病脆弱儿童关怀支持项目工作开展5年后的效果,为下一步工作方案的制订提供依据。方法对卧龙区全部18岁以下居家艾滋病致孤和脆弱儿童进行问卷调查。结果2004年12月和2008年12月分别调查儿童199人和123人。2004年和2008年接受过关怀支持的艾滋病致孤和脆弱儿童分别占93.97%和100%,对关怀支持项目满意度为47.24%和87.00%,下一步关怀需求中,需要生活补助、技能培训、心理健康的分别为36.18%、49.25%、47.24%和20.33%、60.98%、60.98%;两次调查结果的差异有统计学意义(P0.05)。结论卧龙区第三轮艾滋病项目中,居家致孤及脆弱儿童关怀支持项目取得了一定的成效,但存在着生活技能、心理关爱等需进一步加强的问题。     

中国艾滋病致孤儿童生长发育与营养水平及心理健康研究

目的调研中国艾滋病致孤儿童生长发育、营养水平与心理健康状况,为政策制定提供依据。方法按性别、年龄1：1匹配,调查96对艾滋病致孤儿童与非孤儿的身心健康水平,并进行差异比较。结果孤儿组BMIz评分与肩胛下皮褶厚度显著低于非孤儿（P〈0．01）,消瘦明显。孤儿组自尊量表（SES）总分更低,而抑郁问卷（BDI）总分更高（P〈0．05）。男性孤儿身心健康弱势明显,女性组间未见显著性差异。结论中国艾滋病致孤儿童的身心健康脆弱性显著,需探索可持续性更强的孤儿抚养策略,并进行以心理支持为核心的综合健康干预,而且对男性孤儿应给予更多关注。     

艾滋病致孤儿童的心理健康问题研究及相关对策建议

目的了解艾滋病致孤儿童的心理健康问题,提出相关对策和建议。方法采用访谈、追踪调查和心理干预相结合的方法,对受艾滋病影响儿童的心理发展进行了5年的系列研究。结果共追踪调查1 625名儿童,其中孤儿755名,非孤儿童466名,对照儿童404名。发现艾滋孤儿存在着严重的心理问题,艾滋孤儿具有仇恨的心理,封闭、自卑和孤独心理严重,未来发展压力大,悲伤情绪异常严重,双孤和单孤的心理健康状况都很差。在心理干预和3年追踪研究的基础上,提出了相关对策和建议。结论时间解决不了艾滋孤儿的心理健康问题,要重视对艾滋孤儿的心理救助。     

受HIV/AIDS影响儿童面临的问题及应对策略

受艾滋病病毒伎滋病（HIV／AIDS）影响儿童分为四类：（1）感染了HIV的儿童；（2）AIDS致孤儿童；（3）与HIV感染者或AIDS患者共同生活的儿童；（4）AIDS高发区中的儿童。受AIDS影响儿童面临许多问题，主要包括：家庭困难、社会歧视、教育问题、心理问题等。给予受艾滋病影响儿童生理、心理上的关怀是十分重要的，对儿童的成长发育起着积极作用。     

中原地区受AIDS影响的儿童心理健康水平的现况研究

目的 评定中原地区受艾滋病(AIDS)影响的儿童心理健康水平,为改善他们的心理状况提供客观依据.方法 选用SCL-90量表进行问卷调查,应用SAS 8.0进行统计分析.结果 共调查受艾滋病影响的初中生120人,其中双孤儿童33人,单孤儿童43人,受AIDS影响的双亲儿童44人.AIDS致双孤儿童的SCL-90总分(161.36±41.17)分,明显高于AIDS致单孤儿童的(137.37±33.32)分和受AIDS影响的双亲儿童的(141.82±39.36)分.AIDS单孤儿童中女孩的总分(147.07±34.75)明显高于男孩(119.27±21.50).结论 受AIDS影响的儿童心理问题比较严重,在为其提供心理支持的过程中,应根据不同类型、不同性别的特点,进行有针对性地干预.     

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。     

教育工作者对受艾滋病影响儿童关爱态度研究

目的利用“投射技术”与“情境分析”设计问卷,调查教育工作者对受艾滋病影响儿童的关爱态度与意识,为制定干预策略提供依据。方法自行设计问卷,对103名来自艾滋病项目省的教育行政官员、教师进行调查,对结果用SPSS 11.01软件包进行统计分析。结果总体上被调查者对艾滋病病毒(HIV)感染者及受艾滋病影响儿童关爱态度明确,对歧视行为有较深理解和较强识别能力,但仍存在一定程度的消极态度,如对8种歧视行为表示支持的均低于4%,64.1%的人能够认识到歧视给HIV感染者所带来的痛苦。采用传统的提问方式与投射技术提问方式结果差异显著,如传统方式有92.2%的人直接表示能够积极对待HIV感染者,但投射技术提问得到肯定结果的仅为40.8%。结论教育工作者对HIV感染者已具备一定关爱态度与意识,但作为关爱工作核心人群仍有必要接受进一步培训。利用投射技术与情境分析设计问卷进行艾滋病相关问题的调查较之传统问卷更有效,值得推广。     

201名暗娼艾滋病知识及性行为特征分析

目的：了解暗娼艾滋病病毒HIV感染情况及艾滋病知识、态度、信念、行为特征，为制定预防策略提供依据。方法：对201名暗娼采取匿名调查方法进行问卷调查和HIV抗体检测。结果：调查对象HIV抗体检测均为阴性，年龄最小为14岁，初中文化占50．7％；首次性交和卖淫平均年龄分别为18．3岁和18．9岁，21．4％卖淫时从不使用安全套，18．9％既卖淫又吸毒；72．1％听说过艾滋病，但艾滋病相关知识十分缺乏。结论：暗娼艾滋病相关危险行为发生率高，应加强宣传教育和安全套的推广使用，以减少HIV经性传播。     

凉山艾滋病致孤儿童主观幸福感与学校联系感同伴关系和失眠的关系

目的了解凉山州艾滋病致孤儿童主观幸福感现况,探讨其主观幸福感与学校联系感、同伴关系和失眠程度的关系。方法纳入孤儿571名,非孤儿979名,调查社会人口学特征、主观幸福感量表、失眠严重程度指数、学校联系感量表。通过构建结构方程模型分析变量间的关系。结果孤儿主观幸福感得分为(10.04±2.40),非孤儿(10.72±2.26),差异有统计学意义(P0.05)。结构方程模型显示,该地区儿童青少年的同伴关系是主观幸福感的直接保护因素,失眠程度是主观幸福感的直接危险因素,两者通过学校联系感影响主观幸福感的部分中介效应分别为0.180(P0.001,95%CI:0.132～0.237)和-0.069(P0.001,95%CI:-0.103～-0.044),中介效应分别占总效应的31.7%和27.4%。群组分析结果显示,是否孤儿是失眠程度与主观幸福感关系的调节因素。结论凉山艾滋病致孤儿童青少年主观幸福感较低,干预策略应考虑帮助儿童青少年建立良好的同伴关系以及增强学校联系感,并且缓解其失眠情况。     

四川省青少年艾滋病预防知识 态度及行为特征调查

目的调查掌握14～39岁青少年艾滋病预防知识、态度及行为，为艾滋病防治工作提供对策参考。方法采用自编问卷，随机抽样问卷调查成都市、邛崃县、甘洛县500名普通青少年，200名有吸毒史或从事性工作或同性恋的高危人群。结果六成被调查者正确掌握艾滋病预防知识与方法，但存在较多知识“盲点”；高危人群略好于普通人群，成年人（特别是20～29岁成年人）好于未成年人，高文化程度者好于低文化程度者。获得预防知识及信息渠道具有私秘性特点，清醒认识艾滋病的危害，但不很担心其现实威胁，“羞”于与家人或公开谈论预防措施。近一半被调查者未能采取正确的预防措施，预防行为不主动。结论扩大全面、权威宣传教育规模；加强综合预防，实施重点干预，营造宽松社会、家庭氛围，形成群防体系，是艾滋病防治工作取得成效的重要途径。     

An enumeration of orphans and analysis of the problems and wishes of orphans: the case of Kariba,Zimbabwe

In southern Africa, HIV and AIDS accounts for the largest proportion of orphans. Very often the orphaned children become destitute, and young girls in particular become more vulnerable to HIV and AIDS as they try to fend for the rest of the family. This paper reports on the number of orphans in Kariba, Zimbabwe, describing their problems, coping strategies and wishes. The study was carried out in Nyamhunga and Mahombekombe high-density residential areas of Kariba, Zimbabwe. All households in the study area were visited, and a semi-structured questionnaire aimed at enumerating orphans and obtaining information regarding general problems of orphans was administered to heads of households present. In addition, information on the plight, coping strategies and survival wishes of orphans were collected through 15 focus group discussions held with orphans, care givers, community leaders and stakeholders. The prevalence of orphans in Kariba, based on a sample of 3 976 households, was found to be very high (56%) with most of the orphans in the age group 6 – 12 years. The majority of the orphans were paternal and under maternal care. Over 30% of the orphans of schoolgoing age were not in school, and some young girl orphans became involved in commercial sex work. The survival wish list of the orphans included school fees, accommodation, health care provision, adequate food and income-generating projects. However, suggestions on orphan care and needs given by community members were somewhat divergent from the orphans' wish list, indicating that community interventions may not be sensitive to the wishes of those affected. Although the study did not categorise orphans according to cause of death of parents, there are indications that most of the orphans are accounted for by HIV and AIDS.     

Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province, China

OBJECTIVE: To assess the influence of orphanhood due to AIDS on children's nutritional status, psychological well-being and life quality, and to explore appropriate intervention strategies in China. METHODS: In 2005, 186 children aged 8-15 years (93 AIDS orphans and 93 non-orphans) from a rural area of Henan Province were surveyed in a cross-sectional and matched pairs study on nutritional status, psychological health and life quality. RESULTS: We found no compelling evidence for poorer nutritional status in orphans. The nutritional status of both orphans and non-orphans was extremely poor according to the prevalence of stunting, underweight, wasting and anaemia. Depression, low self-esteem and lower quality of life were more frequent in orphans. These differences mainly existed in boys' groups. No significant differences were found between paternal, maternal and double orphans, or orphans in orphanages or extended families. Regression analysis revealed that orphanhood leads to low self-esteem and more depression which contributes to lower quality of life and mediates the association between orphanhood and quality of life. CONCLUSION: The high prevalence of poor nutritional status indicates that basic material needs of children, including AIDS orphans, are not met in rural China. Psychological problems were prominent among orphans and had become the most important contributor of lower life quality. Boys were at least as vulnerable as girls. The living conditions of all children in rural China must be improved; school-based care and support are crucial and would be a cost-effective way to improve the overall life quality of AIDS orphans.     

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。     

The impact of parental HIV/AIDS on children's cognitive ability in rural China

This study examined the impact of parental HIV/AIDS on children's cognitive ability. Cross-sectional data were collected from 1625 children aged 6–18 years, including 755 AIDS orphans, 466 vulnerable children, and 404 comparison children in rural China. Participants completed measures of demographic information and the assessment of cognitive ability (verbal comprehension ability and perceptual reasoning ability). Results showed that the cognitive ability was lower among children affected by HIV/AIDS than comparison children. Double orphans living in kinship care performed better on verbal comprehension ability than children living in orphanage or group home, but not on perceptual reasoning ability. Older children (≥15 years old) scored higher on verbal comprehension ability and younger children (≤11 years old) scored higher on perceptual reasoning ability. Boys scored higher than girls on perceptual reasoning ability but not on verbal comprehension ability. Future studies should explore factors that may hinder the development of cognitive ability of children affected by HIV/AIDS and provide appropriate intervention in this regard.     

Assessing the health status of young AIDS and other orphans in Kampala, Uganda

The huge number of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) orphans is an important feature of the epidemic in sub-Saharan Africa. There are few and conflicting data on the effects of being orphaned on health and nutrition in the highly affected HIV endemic areas of Africa. This study reports findings from a cross-sectional survey on associations between orphan status and health and nutrition parameters in young children of urban Uganda. A high prevalence of orphans was reported from a central Kampala community, with 41% being attributed to HIV/AIDS. Although there was a higher prevalence of self-reported morbidity in orphans than non-orphans, there were no differences in reported treatment seeking behaviour and measured anthropometric parameters. Hence it seems that the extended family system still manages to care for young orphans. Paying school fees for older children should be the primary target for HIV/AIDS impact mitigation programs in urban Uganda.     

Perceived social support and the psychological well-being of AIDS orphans in urban Kenya

Parental deaths due to AIDS seriously affect the psychological well-being of children. Social support may provide an effective resource in the care of vulnerable children in resource-limited settings. However, few studies have examined the relationships between social support and psychological well-being among AIDS orphans. This cross-sectional study was conducted to explore associations between perceived social support (PSS) and the psychological well-being of AIDS orphans, and to identify socio-demographic factors that are associated with PSS. Data were collected from 398 pairs of AIDS orphans (aged 10-18 years) and their caregivers in Nairobi, Kenya. The participants provided information on their socio-demographic characteristics, the children's PSS, and the children's psychological status (based on measures of depressive symptoms and self-esteem). Of the 398 pairs, 327 were included in the analysis. PSS scores of AIDS orphans showed significant correlations with depressive symptoms (ρ =-0.31, p<0.001) and self-esteem (ρ=0.32, p<0.001). Socio-demographic factors, such as HIV-positive status of children (β=3.714, p=0.014) and cohabitation with siblings (β=3.044, p=0.016), were also associated with higher PSS scores. In particular, HIV-infected children (n=37) had higher scores of PSS from a special person (β=2.208, p=0.004), and children living with biological siblings (n=269) also had higher scores of PSS from both a special person (β=1.411, p=0.029) and friends (β=1.276, p=0.039). In conclusion, this study showed that PSS is positively associated with the psychological well-being of AIDS orphans. Siblings and special persons can be effective sources of social support for AIDS orphans, which help to promote their psychological well-being.     

The extent of community and public support available to families caring for orphans in Malawi

There are an estimated 15 million AIDS orphans worldwide. Families play an important role in safeguarding orphans, but they may be increasingly compromised by the HIV/AIDS epidemic. The international aid community has recognized the need to help families continue caring for orphaned children by strengthening their safety nets. Before we build new structures, however, we need to know the extent to which community and public safety nets already provide support to families with orphans. To address this gap, we analyzed nationally representative data from 27,495 children in the 2004-2005 Malawi Integrated Household Survey. We found that communities commonly assisted orphan households through private transfers; organized responses to the orphan crisis were far less frequent. Friends and relatives provided assistance to over 75% of orphan households through private gifts, but the value of such support was relatively low. Over 40% of orphans lived in a community with support groups for the chronically ill and approximately a third of these communities provided services specifically for orphans and other vulnerable children. Public programs, which form a final safety net for vulnerable households, were more widespread. Free/subsidized agricultural inputs and food were the most commonly used public safety nets by children's households in the past year (44 and 13%, respectively), and households with orphans were more likely to be beneficiaries. Malawi is poised to drastically expand safety nets to orphans and their families, and these findings provide an important foundation for this process.     

Household displacement and health risk behaviors among HIV/AIDS-affected children in rural China

When parents die of or are infected with HIV, children might have to leave their own household and be displaced to other living arrangements and some may even be displaced multiple times. The objective of this study is to examine the association between household displacement and health risk behaviors among AIDS orphans (children who have lost one or both of their parents to HIV/AIDS) and vulnerable children (children living with HIV-infected parents) in rural China. The sample consisted of 1015 children (549 AIDS orphans, 466 vulnerable children) in family-based care. The children were assigned to three displacement groups according to the number of household displacement (i.e., none, once, at least twice) after their parents became ill or died of HIV/AIDS. Cigarette smoking, alcohol use, violence, public property destruction, suicidal ideation, and suicide attempt were used to assess the health risk behaviors of these children. Both bivariate and multivariate tests were used to assess the differences in health risk behaviors among displacement groups. The findings indicated that children who were displaced at least twice were more likely to report a higher frequency of public property destruction and suicide ideation than those who were never displaced or displaced once. Multivariate analysis revealed that public property destruction, suicide ideation and suicide attempt were significantly associated with the household displacement among these children, controlling for gender, age, child status (AIDS orphans vs. vulnerable children), and the duration of household displacement. Results in the current study suggest that a stable living environment was important for both AIDS orphans and vulnerable children in communities with a high prevalence of HIV/AIDS. The government, community, and other agencies need to make efforts to avoid frequent household displacement among these children after the HIV-related infection or death of their parents.