Psychosocial Intervention in HIV-Affected Children in Haiti

海地受艾滋病毒影响的儿童的心理社会干预

• 批准号: 7058919
• 负责人: JOIA S MUKHERJEE
• 金额: $ 18.9万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7058919
• 关键词: Caribbean islands; HIV infections; adolescence (12-20); behavioral /social science research tag; caregivers; child psychology; clinical research; coping; health services research tag; high risk behavior /lifestyle; human subject; middle childhood (6-11); parents; pediatric AIDS; prejudice; psychosocial service; rural health; sign /symptom; social psychology; social support network; socioeconomics; therapy design /development

DESCRIPTION (provided by applicant): Worldwide an estimated 15 million children have lost one or both parents to HIV. The stress on children, however, occurs far before the child is orphaned. It has been documented that children whose parents are living with HIV suffer significant psychological distress. Adverse effects of the AIDS pandemic on children affected by HIV are related to both the emotional distress and the worsening economic privation that they experience as parental health deteriorates. Stigma, school difficulties and dropout, diminished nutritional status, lack of shelter, and inadequate access to health care have all been documented among children affected by HIV. Additionally, minors whose parents have died or can no longer provide for them, live with increased vulnerability to exploitation and violence. While the HIV pandemic has put many children in crisis, interventions to mitigate the psychosocial effects on children are lacking in resource-poor settings. Programs to address the effects of the AIDS pandemic on children must be designed, piloted and evaluated in areas of the world with the highest HIV burden. This application is submitted through the R21 mechanism to assess the mental health status of children affected by HIV and to pilot an intervention to support these children and prevent negative psychosocial outcomes. The proposed research will be performed in 6 health facilities in the Harvard Medical School affiliated Partners In Health (PIH) project in rural Haiti. The clinical work of PIH has served as a model for HIV treatment worldwide since it was one of the first sites to provide ART in a resource-poor country. Medications and services are provided to community members free of charge through funds from PEPFAR and the Global Fund to Fight AIDS, TB and Malaria. In this context of comprehensive primary health care and HIV care and treatment, children affected by HIV will be selected for a feasibility study to examine: 1) the prevalence of psychiatric symptoms, level of psychosocial functioning and HIV-risk behaviors among children affected by HIV; 2) the coping skills, social support and psychiatric symptoms of the HIV positive parents and/or caregivers of the children; 3) the association of psychosocial functioning of the child with variables collected for both children and adults. Lastly, a group intervention for HIV affected children will be piloted to generate preliminary data for a larger, R01 study designed to prevent poor outcomes in HlV-affected children.

描述（由申请人提供）：全世界估计有 1500 万儿童因艾滋病毒失去了父母之一或双亲。 然而，孩子们所承受的压力早在孩子成为孤儿之前就已经出现了。据记录，父母感染艾滋病毒的儿童会遭受严重的心理困扰。艾滋病大流行对受艾滋病毒影响的儿童造成的不利影响与他们因父母健康状况恶化而经历的情绪困扰和日益恶化的经济匮乏有关。受艾滋病毒影响的儿童面临耻辱、学业困难和辍学、营养状况恶化、缺乏住所以及无法充分获得医疗保健等问题。此外，父母去世或无法再供养他们的未成年人更容易遭受剥削和暴力。虽然艾滋病毒大流行使许多儿童陷入危机，但在资源匮乏的环境中缺乏减轻儿童心理社会影响的干预措施。 必须在世界上艾滋病毒负担最重的地区设计、试点和评估旨在解决艾滋病大流行对儿童影响的方案。该申请通过 R21 机制提交，旨在评估受艾滋病毒影响的儿童的心理健康状况，并试行一项干预措施来支持这些儿童并防止负面的心理社会结果。拟议的研究将在哈佛医学院附属健康合作伙伴 (PIH) 项目位于海地农村地区的 6 个医疗机构进行。 PIH 的临床工作已成为全球艾滋病毒治疗的典范，因为它是资源匮乏国家最早提供抗逆转录病毒治疗的地点之一。通过总统紧急救援计划和全球抗击艾滋病、结核病和疟疾基金的资金，向社区成员免费提供药物和服务。 在综合初级卫生保健和艾滋病毒护理和治疗的背景下，将选择受艾滋病毒影响的儿童进行可行性研究，以检查：1) 受艾滋病毒影响的儿童中精神症状的患病率、心理社会功能水平和艾滋病毒风险行为; 2) HIV 阳性父母和/或儿童照顾者的应对技巧、社会支持和精神症状； 3) 儿童的心理社会功能与为儿童和成人收集的变量之间的关联。 最后，将对受艾滋病毒影响的儿童进行团体干预试点，为一项更大规模的 R01 研究生成初步数据，该研究旨在防止受艾滋病毒影响的儿童出现不良后果。