艾滋病对贫困农村地区儿童监护人及家庭的影响研究

The impact of HIV/AIDS on caregivers of affected children in rural areas in Anhui,China

目的了解安徽省农村地区受艾滋病影响儿童监护人的情况,为今后开展干预活动提供基线资料。方法采用整群抽样方法,在安徽省阜南县抽取两个艾滋病流行重点村,招募所有符合条件的受艾滋病影响儿童的监护人,用半结构式问卷和面对面访谈方法进行调查。结果在154名调查对象中,女性占58%,年龄在36～45岁占70%,未上过学占48%,已婚占77%,全部是农民,家庭收入≤2500元的占54%。有53%的人将自己或家人的感染状况告诉了别人,81%的人告知了孩子。有54%的人认为自己的生活状况"差"或"很差",45%的人对自己的健康状况不太满意,世界卫生组织生命质量指数平均为66.70,该指数同家庭艾滋病感染状况有关(F=9.40,P<0.01)。女性Zung抑郁分值是25.61,男性23.14,女性明显高于男性(F=9.40,P<0.01);抑郁分值同家庭艾滋病感染情况有关(F=5.82,P<0.01)。有14%的人认为艾滋病使得他们的家庭关系变差了,9%的人认为艾滋病使得他们的家庭关系变好了;有39%的人说曾遇到过歧视。所有监护人都赞同调查表中提出的干预活动,补充的建议中只涉及帮助改善经济状况和孩子的教育两个方面。结论在安徽省阜南县贫困农村地区,对受艾滋病影响儿童的监护人的影响主要包括:经济状况、健康状况、生活质量、家庭生活等方面,存在的需求是多方面的,但他们的主观要求并不高。

Objective To identify the impact of HIV/AIDS on the caregivers and families of affected children in rural areas in Anhui, China, so as to provide preliminary data for future intervention. Methods Two hard-hit villages were selected using cluster sampling method in Funan County, north Anhui. All qualified child caregivers in the two vil- lages were recruited for a face-to-face interview using a semi-structured questionnaire. Results Among the 154 participants, 58% were females, 70% were aged 36--45 years old, 48% were illiterate, 77% were married, all were farmers of which 88% were engaged in other part-time jobs, 54% had an annual household income of less than 2500 yuan. 81 caretakers （53 % ） had disclcsed their HIV positive status to other people, and 124 （81% ） to their children. 54 % of the respondents rated their overall quality of life as ＂lx^r＂ or ＂very poor＂ . 45% of the caretakers were dissatisfied with their health. The average score based on the WHO Quality of Life Scale was 66.70, and it was significantly associated with the family HIV status （F = 9.40, P〈 0.01 ）. The Zung depression score, being 25.61 among the females and 23.14 amongthe males （F = 9.40, P〈 0.01） was significantly associated with the family HIV status （F = 5.82, P 〈0.01 ）. The relationship among the family members had not been changed because of HIV/AIDS among 77% of the caretakers, became worse among 14% of the caretakers, and even became better among 9% of them. 39% of the caretakers reported that they had to deal with HIV/AIDS-related stigma and discrimination. All the caregivers liked all the in- tervention activities proposed by the interviewer and suggested to ＂help the children get a better education＂, ＂improve the children＇s school performance＂, and ＂help with small scale agriculture programs to provide food＂ to improve the quality of life of the HIV/AIDS-affected children and families. Conclusion The impact of HIV/AIDS on the care.givers of affected children in the rural areas was severe, including income, health, quality of life, and family life. The care.givers had high demands in many fields but did not ask much.