PDF(Pubmed)
Abstract：
This study examined the preliminary impact of group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family groups (MFG-FS) on HIV stigma, parenting stress, and the mental health of caregivers of adolescents living with HIV. We analyzed data from the Suubi4Stigma study (2020-2022), a two-year pilot randomized clinical trial for adolescents and their caregivers (N = 89 dyads), recruited from nine health clinics in Uganda. Adolescent-caregiver dyads were randomized to three intervention conditions delivered over three months, with data collected at baseline, three and six-months follow-up. We fitted mixed-effects linear regression models to test the effect of the interventions on caregiver outcomes over time. At six months, caregivers randomized to the MFG-FS condition reported lower levels of stigma by association (mean difference = -1.45, 95% CI = -2.52 - -0.38, p = 0.008), and stigma and discrimination attitudes (mean difference = -3.84, 95% CI = -4.63 - -3.05, p < 0.001), compared to Usual care condition. In addition, caregivers of adolescents randomized to the G-CBT condition reported lower levels of stigma and discrimination attitudes at three months (mean difference = -5.18, 95% CI = -9.13 - -1.22, p = 0.010), and at six months (mean difference = -6.70, 95% CI = -9.28 - -4.12, p < 0.001). Caregiver mental health and parenting stress significantly reduced over time regardless of intervention condition. Findings point to the importance of incorporating stigma reduction components within psychosocial interventions targeting adolescents and families impacted by HIV.
摘要：
这项研究检查了团体认知行为疗法（G-CBT）和通过多个家庭团体（MFG-FS）进行的家庭强化干预对HIV污名的初步影响，育儿压力,以及青少年艾滋病毒携带者的心理健康。我们分析了Suubi4Stigma研究(2020-2022)的数据，一项针对青少年及其照顾者的为期两年的试点随机临床试验（N=89个二元组），从乌干达的9个诊所招募。青少年照顾者二元组被随机分配到三个月内交付的三个干预条件，在基线时收集的数据，三个月和六个月的随访。我们拟合了混合效应线性回归模型，以测试干预措施对照顾者结果的影响。六个月的时候，被随机分配到MFG-FS条件的照顾者报告了通过关联的较低水平的污名（平均差异=-1.45，95％CI=-2.52--0.38，p=0.008），以及污名和歧视态度(平均差=-3.84，95%CI=-4.63--3.05，p<0.001)，与通常的护理条件相比。此外,随机接受G-CBT治疗的青少年的照顾者在三个月时报告的污名和歧视态度水平较低（平均差异=-5.18，95％CI=-9.13--1.22，p=0.010），6个月时（平均差=-6.70，95%CI=-9.28--4.12，p<0.001）。无论干预条件如何，照顾者的心理健康和育儿压力都会随着时间的推移而显着降低。研究结果表明，在针对受艾滋病毒影响的青少年和家庭的心理社会干预措施中纳入减少污名的组成部分的重要性。
