Vulnerable Children and Youth Studies最新文献_第8页

How maternal age links to childhood mortality? A brief analysis from NFHS-4 (2015–2016), India 产妇年龄与儿童死亡率有何关系?印度NFHS-4(2015-2016)的简要分析

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-04-06 DOI: 10.1080/17450128.2022.2058136

Salim Mandal, P. Chouhan

ABSTRACT The study aimed to estimate the relationship between childhood mortality and maternal age using bivariate association and logistic regression using the nationally representative data from India through NFHS-4 (2015–2016). The study reveals that the odds ratio of childhood mortality was comparatively higher among lower aged women (<20 years old) and aged women (30 years and more). The result depicted that childhood mortality was comparatively less among those women of 20–29 age groups and suggests raising maternal education to avoid child marriage and early marriage, not to plan a child at the upper age (>40 years old).

本研究旨在通过NFHS-4(2015-2016)分析印度具有全国代表性的数据，利用双变量关联和逻辑回归来估计儿童死亡率与母亲年龄之间的关系。研究表明，年龄较低的妇女(40岁)儿童死亡率的比值比相对较高。

引用次数: 1

Poor self-regulation in eating behaviour during the COVID-19 lockdown contributes to weight gain among young adults in Malaysia 新冠肺炎封锁期间饮食行为自我调节不良导致马来西亚年轻人体重增加

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-03-30 DOI: 10.1080/17450128.2022.2059127

S. Tan, S. Tan, Chin Xuan Tan

ABSTRACT This cross-sectional study aims to investigate physical activity, self-regulation in eating behaviour, and their associations with body weight trajectory during the COVID-19 nationwide lockdown (Movement Control Order, MCO) in Malaysia. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess physical activity and sitting time during the MCO. Self-regulation in eating behaviour was evaluated with the Self-Regulation of Eating Behaviour Questionnaire (SREBQ), while weight trajectory was self-reported by the respondents. Of the 200 young adults, 82.0% were reported to be physically active during the MCO, with a weekly physical activity intensity of 4551.16 ± 4744.89 MET-minute. Young adults in this study spent 8.63 ± 4.47 hours/day on sedentary activities during the MCO. It is also noted that the majority (71.0%) had medium self-regulation in eating behaviour during the lockdown, with a mean score of 3.08 ± 0.49. Slightly more than half of the young adults (57.0%) gained weight since the MCO enforcement, with an average weight increment of 1.28 ± 0.60 kg. Findings from the multinomial logistic regression suggested that self-regulation in eating behaviour was a significant predictor for weight trajectory during the MCO. Young adults who attained a higher score in SREBQ were more likely in sustained weight (AOR = 2.514, p = 0.024, CI: 1.129–5.597) and weight loss (AOR = 2.624, p = 0.011, CI: 1.250–5.507) categories. In conclusion, poor response to food cues (poor self-regulation in eating behaviour), but not physical inactivity, led to weight gain during the MCO in Malaysia.

摘要本横断面研究旨在调查在新冠肺炎马来西亚全国封锁期间的身体活动、饮食行为的自我调节及其与体重轨迹的关系。采用国际体育活动问卷简表（IPAQ-SF）评估MCO期间的体育活动和久坐时间。饮食行为的自我调节通过饮食行为自我调节问卷（SREBQ）进行评估，而体重轨迹由受访者自我报告。据报道，在200名年轻人中，82.0%的人在MCO期间进行了体育活动，每周体育活动强度为4551.16±4744.89 MET分钟。本研究中的年轻人在MCO期间每天花费8.63±4.47小时进行久坐活动。还注意到，大多数人（71.0%）在封锁期间的饮食行为具有中等的自我调节能力，平均得分为3.08±0.49。自实施MCO以来，略多于一半的年轻人（57.0%）体重增加，平均体重增加1.28±0.60 kg。多项逻辑回归的结果表明，饮食行为的自我调节是MCO期间体重轨迹的重要预测因素。SREBQ得分较高的年轻人更有可能在持续体重（AOR=2.514，p=0.024，CI:1.129-5.597）和减肥（AOR=2.624，p=0.011，CI:1.250-5.507）类别中得分。总之，在马来西亚的MCO期间，对食物线索的不良反应（饮食行为的自我调节不良），而不是身体不活动，导致了体重增加。

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引用次数: 2

Violence against homeless gay and transgender youth in Pakistan – a short report 巴基斯坦对无家可归的同性恋和跨性别青年的暴力行为-一个简短的报告

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-03-27 DOI: 10.1080/17450128.2022.2058135

M. N. Noor

ABSTRACT Violence against youth with diverse sexual and gender identities is an understudied area in Pakistan. This article explores how homeless gay and transgener youth (HGTY) experience multiple forms of violence and how social structural conditions produce contexts for violence against them. This study is based on qualitative interviews with fourteen HGTY, aged 16–25 years old. The interviews suggest that participants experienced multiple forms of violence simultaneously. Social structures like religion, ethnicity, and politics shaped broader cultural intolerance for sexual and/or gender diversity. Not being able to conform to social norms of gender and sexuality not only contributed to violence against participants but shaped their trajectories into homelessness and sex work. The ‘new’ identities of being homeless and being sex workers intersected with their gay and, trans identities, exacerbating their vulnerability. The findings indicate that there is an urgent need for law supportive of sexuality and gender diverse youth to mitigate experiences of violence.

摘要针对具有不同性和性别特征的青年的暴力行为在巴基斯坦是一个研究不足的领域。本文探讨了无家可归的同性恋和变性青年（HGTY）如何经历多种形式的暴力，以及社会结构条件如何产生针对他们的暴力。本研究基于对14名年龄在16-25岁之间的HGTY的定性访谈。访谈表明，参与者同时经历了多种形式的暴力。宗教、种族和政治等社会结构形成了对性和/或性别多样性的更广泛的文化不容忍。无法遵守性别和性行为的社会规范不仅导致了对参与者的暴力行为，还使他们陷入了无家可归和性工作的境地。无家可归和性工作者的“新”身份与他们的同性恋和跨性别身份交织在一起，加剧了他们的脆弱性。调查结果表明，迫切需要支持性行为和性别多样化青年的法律，以减轻暴力经历。

引用次数: 2

Other people’s children and the critical role of the social service workforce 他人子女和社会服务人员的关键作用

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-03-03 DOI: 10.1080/17450128.2022.2040762

C. Desmond, Kathryn Watt, M. Tomlinson, John Williamson, L. Sherr, M. Sullivan, L. Cluver

ABSTRACT Understanding the needs of your child is complicated. Understanding the varied needs of a population of children with whom you have no direct contact is the near impossible challenge policy makers, government planners and donors face when making policy or selecting interventions to fund and implement. They cannot unpack children’s individual needs and so must predict what is most important for a given population and which services to prioritise. This can be simplified by assuming that the needs of other people’s children are hierarchical: basic needs, such as food and shelter, must be met before considering higher-order needs. This conceptualisation justifies a focus on basic needs and decision makers can ignore higher-order needs and the complex interventions they may require, because both are assumed to be of secondary importance. Assuming a hierarchy of needs is a mistake. By drawing on examples from the literature, we outline how children, our own and other people’s, have non-hierarchical needs and thus caring for them is a balancing act, best done by those close to them. This conceptualisation highlights the importance of supporting families to support children. For a subset of families who are struggling, additional family strengthening interventions may be needed. In the relatively rare cases that such interventions are insufficient as family function is severely compromised, more intensive interventions may be necessary, but must be undertaken with great care and skill. Social services are critical because they have the potential to facilitate the intensive interventions when they are required, and while they are not required by all, for some of the most vulnerable children they are essential. The quality standards of such a service will be key in meeting the needs of other people’s children.

了解孩子的需求是很复杂的。决策者、政府规划者和捐助者在制定政策或选择资助和实施的干预措施时，几乎不可能面对的挑战是，了解与你没有直接接触的儿童群体的各种需求。他们无法了解儿童的个人需求，因此必须预测对特定人群来说什么是最重要的，哪些服务应该优先考虑。这可以通过假设其他人的孩子的需求是分层的来简化:在考虑更高层次的需求之前，必须满足诸如食物和住所等基本需求。这种概念化证明了对基本需求的关注是合理的，决策者可以忽略高阶需求及其可能需要的复杂干预，因为两者都被认为是次要的。假设需求层次是错误的。通过引用文献中的例子，我们概述了我们自己和别人的孩子是如何有不分等级的需求的，因此照顾他们是一种平衡行为，最好由他们亲近的人来做。这一概念强调了支持家庭支持儿童的重要性。对于一部分正在挣扎的家庭，可能需要额外的家庭强化干预措施。在相对罕见的情况下，由于家庭功能受到严重损害，这种干预措施是不够的，可能需要更密集的干预措施，但必须非常小心和熟练地进行。社会服务是至关重要的，因为它们有可能在需要时促进密集干预，虽然不是所有人都需要，但对于一些最脆弱的儿童来说，它们是必不可少的。这种服务的质量标准将是满足他人子女需求的关键。

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引用次数: 1

Tablet vs. Book learning: association with memory, attention, and learning abilities among lebanese children 平板电脑与书本学习：黎巴嫩儿童记忆、注意力和学习能力的关系

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-02-27 DOI: 10.1080/17450128.2022.2042447

Jessika Tawil, C. Haddad, Youssef Farchakh, H. Sacre, Rita Nabout, S. Obeid, P. Salameh, S. Hallit

ABSTRACT In Lebanon, the methods of teaching employed are mostly conventional. Teachers spend a lot of time giving lessons and homework to students, as well as reading assignments and correcting exercises completed in class. Students usually play a passive role in the education process; they listen calmly, occasionally question what is presented, and copy texts and information dictated by the teacher. Textbooks are the major source of instruction, yet many Lebanese schools have partially introduced electronic devices, and have discreetly started to rely on them. Given the reported discrepancies between textbooks and tablets learning, it was essential to conduct a Lebanese study that compares both entities. To assess the influence of textbooks and tablets on cognition and attention, it was also necessary to consider the schooling age that is critical for understanding the human brain and cognition. Therefore, the objective of this study was to assess the association between of tablet vs. book learning on memory, attention, and learning abilities among Lebanese children. This cross-sectional study, conducted between January-May 2019, enrolled 566 students aged of 11–13 years. Two schools were chosen conveniently for this study, one of them uses the Tablet and text books for students’ learning whereas the second one uses text books exclusively. Students were randomly chosen from the list given by the school administration. Textbook learning was significantly associated with better episodic and visual memory, better attention, processing speed and mathematic skills compared to tablets and textbook learning. Learning is evolving to another level and forever changing. Many studies should be conducted in order to understand the importance of merging new and old techniques to ensure that the next generations are receiving what can positively affect their cognitive skills and their performance.

在黎巴嫩，采用的教学方法大多是传统的。老师花很多时间给学生上课和做作业，以及阅读作业和批改课堂上完成的练习。学生通常在教育过程中扮演被动的角色;他们平静地听着，偶尔会对所呈现的内容提出质疑，并抄写老师口授的文本和信息。教科书是教学的主要来源，但许多黎巴嫩学校已经部分引进电子设备，并谨慎地开始依赖它们。鉴于教科书和平板电脑学习之间所报告的差异，有必要进行一项黎巴嫩研究，对这两个实体进行比较。为了评估教科书和平板电脑对认知和注意力的影响，也有必要考虑上学年龄，这是了解人类大脑和认知的关键。因此，本研究的目的是评估平板电脑与书本学习对黎巴嫩儿童记忆、注意力和学习能力的影响。这项横断面研究于2019年1月至5月进行，招募了566名11-13岁的学生。我们方便地选择了两所学校进行研究，其中一所学校使用平板电脑和教科书进行学生学习，而另一所学校则完全使用教科书。学生是从学校行政部门提供的名单中随机抽取的。与平板电脑和教科书学习相比，教科书学习与更好的情景记忆和视觉记忆、更好的注意力、处理速度和数学技能显著相关。学习正在向另一个层次发展，并且永远在变化。为了了解新旧技术结合的重要性，应该进行许多研究，以确保下一代接受能够对他们的认知技能和表现产生积极影响的东西。

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引用次数: 2

Knowledge levels regarding sexually transmitted diseases among individuals with visual impairment: a cross-sectional study 视障患者性传播疾病知识水平的横断面研究

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-02-09 DOI: 10.1080/17450128.2022.2038400

Hatice Güdül Öz, H. Yangın, Arzu Akpinar

ABSTRACT This study aimed to discover characteristics of individuals with visually impairment (VI) that are associated with lower knowledge of sexually transmitted diseases (STDs), in Turkey. In this cross-sectional study, data were collected online from 110 individuals with VI. Data analysis was performed using descriptive statistics and chi-square test. Knowledge regarding STDs varies significantly with gender, marital status, and education status (p < .05). The study provides evidence to indicate that participants have an inadequate of information the mode of transmission, prevention, and various types of STDs. The results call for intensified STD-related education and awareness creation for individuals with VI.

摘要本研究旨在发现土耳其视障患者的特征，这些特征与性传播疾病（STDs）知识水平较低有关。在这项横断面研究中，从110名VI患者中在线收集数据。使用描述性统计和卡方检验进行数据分析。关于性传播疾病的知识因性别、婚姻状况和教育状况而异（p＜0.05）。该研究提供的证据表明，参与者对传播方式、预防和各种类型的性传播疾病信息不足。研究结果呼吁加强对VI患者的性病相关教育和提高认识。

引用次数: 1

Behavioral problems and its associated factors among siblings of children with developmental disabilities: analytical cross-sectional study 发育障碍儿童兄弟姐妹的行为问题及其相关因素:分析性横断面研究

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-01-03 DOI: 10.1080/17450128.2021.2023788

Apsara Ali Nathwani, M. Lakhdir, S. Azam, A. Siddiqui

ABSTRACT The typically developing siblings of children with disabilities are vulnerable to behavioral problems as they grow up in an environment of considerable stress. Yet, the needs and behavior problems of these siblings are often neglected especially in Pakistan. In this cross-sectional study, we assessed the behavior problems among siblings of children with developmental disabilities. The strength and difficulties questionnaire (SDQ) was administered on 250 siblings (aged 6–17 years) of children with a developmental disability (Autism, Intellectual disability (ID), Down Syndrome (DS), and Attention Deficit Hyperactive Disorder (ADHD)) attending special education institutions in Karachi, Pakistan. Multiple linear regression was applied to assess the relationship between SDQ scores and other demographic, parental, and disability-related factors. Adjusted beta coefficients were reported along with a 95% confidence interval. The average SDQ score was found to be 14 ± 6 among the siblings of children with developmental disabilities. Multivariable analysis showed that the estimated mean SDQ score was almost twice among siblings of children with ADHD (95% CI: 0.73–3.48) and ID (95% CI: 0.64–3.16) than siblings of children with Down syndrome. Also, the mean SDQ score was 8 units higher among siblings of children with a severe developmental disability compared to mild disability (95% CI: 6.79–9.47). The findings of the current study emphasize the need for appropriate mental health services, using a family-focused approach from therapeutic and counseling platforms to the siblings, parents, and disabled brother/sister for early identification and management of behavior issues. Abbreviations: ADHD: Attention Deficit Hyperactive Disorder; AKU: Aga Khan University; β: Beta Coefficient (Slope); βo: Intercept; CHS: Community Health Sciences; DS: Down syndrom; ERC: Ethical Review Committee; ID: Intellectual Disability; MLR: Multiple Linear Regression; SDQ: Strengths and Difficulties Questionnaire; SES: Socioeconomic Status; TD: Typically Developing

摘要残疾儿童的典型发育中的兄弟姐妹在压力很大的环境中长大，很容易出现行为问题。然而，这些兄弟姐妹的需求和行为问题往往被忽视，尤其是在巴基斯坦。在这项横断面研究中，我们评估了发育障碍儿童兄弟姐妹的行为问题。对巴基斯坦卡拉奇特殊教育机构的250名发育残疾儿童（自闭症、智力残疾、唐氏综合症和注意力缺陷多动障碍）的兄弟姐妹（6-17岁）进行了力量和困难问卷（SDQ）。多元线性回归用于评估SDQ评分与其他人口统计学、父母和残疾相关因素之间的关系。报告了调整后的β系数以及95%的置信区间。在发育障碍儿童的兄弟姐妹中，SDQ的平均得分为14±6。多变量分析显示，患有多动症（95%CI:0.73–3.48）和ID（95%CI:0.64–3.16）的儿童的兄弟姐妹的估计平均SDQ得分几乎是患有唐氏综合症儿童的兄弟姊妹的两倍。此外，与轻度残疾相比，患有严重发育残疾儿童的兄弟姐妹的平均SDQ得分高出8个单位（95%CI:6.79-9.47）。当前研究的结果强调了对适当心理健康服务的需求，从治疗和咨询平台到兄弟姐妹、父母、，以及残疾兄弟姐妹，以便早期识别和管理行为问题。缩写：多动症：注意力缺陷多动障碍；AKU：阿加汗大学；β：贝塔系数（斜率）；βo：截距；社区卫生科学；DS：唐综合征；ERC：伦理审查委员会；ID：智力残疾；MLR：多元线性回归；SDQ：优势和困难问卷；SES：社会经济地位；TD：典型发展

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引用次数: 3

The relationships between resilience, care environment, and social-psychological factors in orphaned and separated adolescents in western Kenya. 肯尼亚西部孤儿和失散青少年心理弹性、护理环境和社会心理因素之间的关系。

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-01-01 DOI: 10.1080/17450128.2022.2067381

Sarah C Sutherland, Harry S Shannon, David Ayuku, David L Streiner, Olli Saarela, Lukoye Atwoli, Paula Braitstein

The relationships between care environment, resilience, and social factors in orphaned and separated adolescents and youths (OSAY) in western Kenya are complex and under-studied. This study examines these relationships through the analysis of survey responses from OSAY living in Charitable Children's Institutes (CCI) and family-based care settings (FBS) in Uasin Gishu County, Kenya. The associations between 1) care environment and resilience (measured using the 14-item Resilience Scale); 2) care environment and factors thought to promote resilience (e.g. social, family, and peer support); and 3) resilience and these same resilience-promoting factors, were examined using multivariable linear and logistic regressions. This cross-sectional study included 1202 OSAY (50.4% female) aged 10-26 (mean=16; SD=3.5). The mean resilience score in CCIs was 71 (95%CI=69-73) vs. 64 (95%CI=62-66) in FBS. OSAY in CCIs had higher resilience (β=7.67; 95%CI=5.26-10.09), social support (β=0.26; 95%CI=0.14-0.37), and peer support (β=0.90; 95%CI=0.64-1.17) than those in FBS. OSAY in CCIs were more likely to volunteer than those in FBS (OR=3.72; 95%CI=1.80-7.68), except in the male subgroup. Family (β=0.42; 95%CI=0.24-0.60), social (β=4.19; 95%CI=2.53-5.85), and peer (β=2.13; 95%CI=1.44-2.83) relationships were positively associated with resilience in all analyses. Volunteering was positively associated with resilience (β=5.85; 95%CI=1.51-10.19). The factor most strongly related to resilience in both fully adjusted models was peer support. This study found a strong relationship between care environment and resilience. Care environment and resilience each independently demonstrated strong relationships with peer support, social support, and participating in volunteer activities. Resilience also had a strong relationship with familial support. These data suggest that resilience can be developed through strategic supports to this vulnerable population.

肯尼亚西部孤儿和失散青少年(OSAY)的护理环境、复原力和社会因素之间的关系复杂且研究不足。本研究通过分析生活在肯尼亚瓦辛吉舒县慈善儿童机构(CCI)和基于家庭的护理机构(FBS)的OSAY的调查反馈来检验这些关系。1)护理环境与心理弹性的关系(使用14项心理弹性量表测量);2)被认为促进心理弹性的护理环境和因素(如社会、家庭和同伴支持);3)采用多变量线性回归和逻辑回归对弹性和这些相同的弹性促进因素进行了检验。本横断面研究纳入1202例10-26岁的OSAY患者(50.4%为女性)(平均16岁;SD = 3.5)。CCIs的平均恢复力评分为71分(95%CI=69-73)， FBS的平均恢复力评分为64分(95%CI=62-66)。CCIs的OSAY具有更高的恢复力(β=7.67;95%CI=5.26-10.09)，社会支持(β=0.26;95%CI=0.14-0.37)，同伴支持(β=0.90;95%CI=0.64-1.17)。CCIs中的OSAY比FBS中的OSAY更倾向于自愿(OR=3.72;95%CI=1.80-7.68)，男性亚组除外。家庭(β= 0.42;95%CI=0.24-0.60)，社会(β=4.19;95%CI=2.53-5.85)，同行(β=2.13;95%CI=1.44-2.83)与恢复力呈正相关。志愿服务与心理弹性呈正相关(β=5.85;95% ci = 1.51 - -10.19)。在两个完全调整的模型中，与复原力关系最密切的因素是同伴支持。该研究发现，护理环境与心理弹性之间存在很强的关系。护理环境和恢复力分别与同伴支持、社会支持和参与志愿者活动有很强的关系。适应力也与家庭支持密切相关。这些数据表明，可以通过对这一弱势群体的战略支持来发展复原力。

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引用次数: 2

The Role of Self-Efficacy in HIV treatment Adherence and its interaction with psychosocial factors among HIV Positive Adolescents in Transition to Adult Care in Kenya. 自我效能感在HIV治疗依从性中的作用及其与肯尼亚HIV阳性青少年向成人护理过渡的社会心理因素的相互作用。

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-01-01 DOI: 10.1080/17450128.2021.1954736

Nyawira Gitahi-Kamau, Samuel Wahome, Peter Memiah, Elizabeth A Bukusi

Adolescents and young adults (15-24 yrs.) have poorer HIV clinical outcomes than adults. Despite this, there is minimal data on individual-level factors such as self-efficacy towards antiretroviral adherence among perinatally infected adolescents living with HIV in sub-Saharan Africa. Our study examined the interaction between antiretroviral treatment adherence self-efficacy and other psychosocial factors among adolescents receiving care in Nairobi, Kenya. We enrolled perinatally infected Adolescent Living with HIV (ALWHIV) 16-19 yrs. who were accessing care routinely at the HIV clinic. We measured self-reported ART adherence (7-day recall) and defined optimal adherence as >95%, and conducted a regression analysis to identify independently associated factors. Mediation analysis explored interactions between the psychosocial variables. We enrolled 82 ALWHIV median age 17 (IQR 16,18) who had been on ART for a median age of 11 yrs. (IQR 7,13). Sixty-four per cent (52) of the ALWHIV reported optimal adherence of >95%, and 15% reported missing doses for three or more months. After controlling for the other covariates, self-esteem, high viral load and an adherence level > 95% were significantly associated with adherence self-efficacy. Self-esteem was significantly associated with adherence self-efficacy and social support (p<0.001 and p=0.001), respectively. The paramed test indicated that the association between self-efficacy and adherence was mediated by self-esteem with a total effect of OR 6.93 (bootstrap 95% CI 1.99-24.14). Adherence self-efficacy was also mediated by self-esteem in developing adherence behavior. Interventions focused on increasing adherence among ALWHIV should include self-esteem building components.

青少年和年轻人(15-24岁)的艾滋病毒临床结果比成年人差。尽管如此，撒哈拉以南非洲地区感染艾滋病毒的围产期青少年对抗逆转录病毒依从性的自我效能等个人层面因素的数据很少。我们的研究考察了在肯尼亚内罗毕接受治疗的青少年中抗逆转录病毒治疗依从性、自我效能和其他社会心理因素之间的相互作用。我们招募了围产期感染艾滋病毒(ALWHIV)的16-19岁青少年。他们在艾滋病毒诊所接受常规治疗。我们测量了自我报告的ART依从性(7天回忆)，并将最佳依从性定义为>95%，并进行回归分析以确定独立相关因素。中介分析探讨了社会心理变量之间的相互作用。我们招募了82例中位年龄为17岁(IQR为16,18)的ALWHIV患者，他们接受ART治疗的中位年龄为11年。(差7—13)。64%(52)的ALWHIV报告了>95%的最佳依从性，15%报告了3个月或更长时间的剂量缺失。在控制其他协变量后，自尊、高病毒载量和> 95%的依从性水平与依从性自我效能显著相关。自尊与依从性、自我效能和社会支持显著相关(p

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引用次数: 4

Sexual debut and risk behaviors among orphaned and vulnerable children in Zambia: which protective deficits shape HIV risk? 赞比亚孤儿和弱势儿童的初次性行为和风险行为:哪些保护性缺陷塑造了艾滋病毒风险?

IF 1.1 Q4 FAMILY STUDIES

Vulnerable Children and Youth Studies

Pub Date : 2022-01-01 Epub Date: 2021-09-13 DOI: 10.1080/17450128.2021.1975858

Joseph G Rosen, Nkomba Kayeyi, Mwelwa Chibuye, Lyson Phiri, Edith S Namukonda, Michael T Mbizvo

Orphaned and vulnerable children (OVC) are not only affected by, but also rendered at-risk of, HIV due to overlapping deficits in protective assets, from school to household financial security. Drawing from a protective deficit framework, this study examines correlates of sexual risk - including multiple sexual partnerships, unprotected sex, and age at sexual debut - among OVC aged 13-17 years in Zambia. In May-October 2016, a two-stage stratified random sampling design was used to recruit OVC and their adult caregivers (N = 2,034) in four provinces. OVC-caregiver dyads completed a structured interview addressing household characteristics, protective assets (i.e. finances, schooling, and nutrition), and general health and wellbeing. Associations of factors derived from the multi-component protective deficits framework were examined using multivariable ordered logistic regression, comparing sexually inexperienced OVC to those with a sexual debut and reporting ≥1 sexual behavior(s). A sub-analysis of older (ages 15-17) OVC identified correlates of early (before age 15) and later (at or after age 15) sexual debut using multinomial logistic regression. Among 735 OVC aged 13-17, 14% reported a sexual debut, among whom 14% and 22% reported 2+ past-year partners and non-condom last sex, respectively. Older age (Adjusted Odds Ratio [aOR] = 2.08, 95% Confidence Interval [CI] 1.32-3.27), male sex (aOR = 1.90, CI 1.22-2.96), not having a birth certificate (aOR = 2.05, CI 1.03-4.09), out-of-school status (aOR = 2.63, CI 1.66-4.16), and non-household labor (aOR = 1.84, CI 1.01-3.38) were significantly associated with higher sexual risk. Male sex was the only factor significantly associated with early sexual debut in multivariable analysis. Sexual risk-reduction strategies require age- and sex-specific differentiation and should be prioritized for OVC in financially distressed households.

孤儿和弱势儿童(OVC)不仅受到艾滋病毒的影响，而且由于从学校到家庭经济安全等保护性资产的重叠赤字，他们也面临着感染艾滋病毒的风险。从保护性缺陷框架出发，本研究考察了赞比亚13-17岁的OVC中性风险的相关性，包括多性伙伴关系、无保护的性行为和初次性行为年龄。2016年5 - 10月，采用两阶段分层随机抽样设计，在4个省份招募OVC及其成年照顾者(N = 2034)。ovc照顾者夫妇完成了一项结构化访谈，涉及家庭特征、保护性资产(即财务、学校教育和营养)以及一般健康和福祉。采用多变量有序逻辑回归，比较无性经验的OVC与初次有性行为且报告≥1次性行为的OVC，研究了多成分保护性缺陷框架中相关因素的相关性。使用多项逻辑回归对年龄较大(15-17岁)的OVC进行亚分析，确定了早(15岁之前)和晚(15岁或之后)初次性行为的相关性。在735名13-17岁的OVC中，14%的人报告有初次性行为，其中14%和22%的人分别报告有2年以上的性伴侣和未使用安全套的最后一次性行为。年龄较大(调整优势比[aOR] = 2.08, 95%可信区间[CI] 1.32-3.27)、男性(aOR = 1.90, CI 1.22-2.96)、没有出生证明(aOR = 2.05, CI 1.03-4.09)、失学状况(aOR = 2.63, CI 1.66-4.16)和非家庭劳动(aOR = 1.84, CI 1.01-3.38)与较高的性风险显著相关。在多变量分析中，男性是唯一与早期性行为有显著关系的因素。降低性风险的策略需要根据年龄和性别进行区分，并应优先针对经济困难家庭中的OVC。

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引用次数: 4