RESUMO
Active visualization, the use of dynamic representation of internal processes, is associated with increased knowledge and adherence to ART among people living with HIV. The current pilot intervention study tested the effectiveness of an online visualization for HIV prevention among 146 at-risk youth. Youth were randomized to a standard PrEP briefing or an online visualization. PrEP knowledge, attitudes, and uptake were self-reported at baseline and 3-months. Knowledge of PrEP increased, but there were no changes in preferences or uptake. Active visualization delivered online may be a useful educational tool for PrEP but not for shifting youth's uptake.
Assuntos
Síndrome da Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Adolescente , Humanos , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , AutorrelatoRESUMO
OBJECTIVE: The main objective of the study was to examine the association of migration with child growth, cognition and behaviour in South Africa. METHODS: Secondary analysis assessing effects of migration on child outcomes among a population cohort of women and children (n = 1238) recruited in Cape Town, South African townships and repeatedly assessed from birth to age eight. Logistic regression models analysed sociodemographic predictors of migration and longitudinal models assessed the association of child migration, with or without their mother, on child growth, cognition and behavioural outcomes. RESULTS: By 8 years post-birth, 41% of children born in the townships in Cape Town had migrated to the rural Eastern Cape. Staying in Cape Town, or not migrating, was associated with having an older mother. Children who migrated with their mothers were shorter and weighed less than those who did not migrate. Children who migrated had larger vocabularies and those who migrated with their mothers had fewer behavioural problems than children who stayed in Cape Town. CONCLUSION: Migration in South Africa between peri-urban Cape Town and rural Eastern Cape areas during a child's early years is common and is associated with both positive and negative child outcomes.
Assuntos
Mães , População Rural , População Negra , Criança , Cognição , Feminino , Humanos , África do Sul/epidemiologiaRESUMO
OBJECTIVE: This is a secondary analysis examining neighborhood factors predicting high rates of child resilience in South African Township neighborhoods. METHODS: A population cohort of South African pregnant women (98%; n = 1238), were recruited and assessed across five years with high follow-up rates (83-96%). Resilient children were identified based on consistently meeting global standards for growth, cognitive functioning, and behavior. Community infrastructure, maternal risks, and caretaking behaviors were examined based on neighborhood as predictors of childhood resilience. RESULTS: The rate of resilient children varied significantly by neighborhood (9.5% to 27%). Mothers living in high prevalence neighborhoods (HPN) compared to low prevalence neighborhoods (LPN) were older and more likely be living with three or more people in formal housing with access to water and electricity. In the HPN, resilient children had more food security and were less likely to have mothers with depressed mood. Migration to rural areas occurred more frequently among resilient compared to non-resilient children in the HPN. CONCLUSION: This study applies a novel measure of resilience that is multidimensional and longitudinally defined. Living in formal housing with consistent access to food was associated with resilience. Migration to rural areas among families living in HPN suggests that rural areas could be protective. TRIAL REGISTRATION: ClinicalTrials.gov registration #NCT00996528.
Assuntos
Características de Residência , Resiliência Psicológica , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mães/psicologia , Gravidez , África do Sul/epidemiologiaRESUMO
Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers' histories of risk and children's behavior problems at 3 and 5 years of age. IPV, food insecurity, maternal depressed mood, and geriatric pregnancy (at age of 35 or older) were consistently associated with children's internalizing and externalizing behavior problems. Aggressive behavior was more prevalent among 3- and 5-year olds boys, and was associated with maternal alcohol use. The effects of these factors on child behavior were more prominent than maternal HIV status. There is a continuing need to reduce IPV and household food insecurity, as well as supporting older, depressed, alcohol using mothers in order to address children's behavioral needs.
Assuntos
Agressão , Filho de Pais com Deficiência/psicologia , Depressão , Insegurança Alimentar , Violência por Parceiro Íntimo/estatística & dados numéricos , Idade Materna , Mães/psicologia , Comportamento Problema , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Infantil , Transtornos do Comportamento Infantil , Pré-Escolar , Feminino , Humanos , Masculino , Gravidez , África do Sul/epidemiologiaRESUMO
Adherence to antiretroviral therapy (ART) among youth remains low. We piloted an adapted active visualization device that demonstrates how ART works in the body. Youth living with HIV were randomized to: (1) standard care (n = 14) or the (2) adapted active visualization intervention (n = 14) and 71% of the sample (n = 19) were re-assessed on viral load, adherence behaviors, and illness perceptions 2.5 months later. Intervention youth had lower viral loads, reported less difficulty in adhering to ART, and more motivation and control over their HIV than standard care at follow-up. Active visualization may be an acceptable tool to address ART adherence among youth.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Adolescente , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , Motivação , Carga ViralRESUMO
With long-acting injectable antiretroviral therapy likely to be a treatment option for people living with HIV (PLWH), it is critical to assess its acceptability among potential end-users. Based on formative qualitative work and our own ongoing development of targeted long-acting products in nanosuspension formulations, we created eight hypothetical medication scenarios varying along six dichotomous attributes: administration location (home versus [vs.] clinic), dosing frequency (every 2 weeks vs. 1 week), injections per dose (one vs. two), injection pain (mild vs. moderate), injection site reaction (mild vs. moderate), and effectiveness (better vs. same as pills). PLWH from three outpatient care clinics in Seattle, WA and Riverside, CA rated acceptability (i.e., willingness to try each hypothetical medication) from 0 (very unlikely) to 100 (very likely). In conjoint analyses, we examined level and correlates of acceptability, the impact of each attribute on overall acceptability, and moderators of this effect. Participants (median age 52 years; 71% male, 34% White, 36% Black/African American, 20% Hispanic) rated acceptability of the 8 scenarios from 47.8 (standard deviation [SD] = 37.0) to 68.8 (SD = 34.1), with effectiveness (impact score = 7.3, SD = 18.7, p = 0.005) and dosing frequency (impact score = 5.7, SD = 19.6, p = 0.034) the only attributes with a significant impact on acceptability. There were no statistically significant differences in overall acceptability according to any participant socio-demographic or other characteristic; however, gender, education, employment status, and experience with and hatred/avoidance of injections moderated some effects. Overall acceptability for targeted long-acting antiretroviral treatment as proposed was modest, with superior effectiveness and lower dosing frequency most impactful on acceptability. Future acceptability research should continue to evaluate specific products in development with a full range of conjoint analytic and other techniques.
Assuntos
Antirretrovirais , Infecções por HIV , Aceitação pelo Paciente de Cuidados de Saúde , Envio de Mensagens de Texto , Negro ou Afro-Americano , Antirretrovirais/administração & dosagem , Preparações de Ação Retardada , Feminino , Infecções por HIV/tratamento farmacológico , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In the era of widespread antiretroviral therapy (ART), consequences of being HIV-exposed is unclear for children, especially in rural communities. A population sample of consecutive births (470/493) in the Eastern Cape of South Africa (SA) were recruited and reassessed at five points over the first 24 months. Maternal and child outcomes between mothers living with and without HIV were assessed using multiple linear and logistic regressions. At birth, 28% of the sample was mothers living with HIV and five additional mothers seroconverted. All mothers living with HIV reported taking ART. The rate of depressed mood and IPV was similar across serostatus. However, mothers living with HIV significantly decreased their alcohol use after learning about their pregnancy and were more likely to exclusively breastfeed when compared to mothers without HIV. Despite maternal HIV status, children had similar growth across the first 24 months of life. Future work is needed to assess if these developmental trajectories will persist.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Aleitamento Materno/estatística & dados numéricos , Saúde da Criança , Infecções por HIV/tratamento farmacológico , Saúde Materna , Mães/estatística & dados numéricos , População Rural/estatística & dados numéricos , Criança , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Saúde Mental , Avaliação de Resultados em Cuidados de Saúde , Gravidez , África do Sul/epidemiologia , Adulto JovemRESUMO
BACKGROUND: More than 50% of Africa's population lives in rural areas, which have few professional health workers. South Africa has adopted task shifting health care to Community Health Workers (CHWs) to achieve the Sustainable Development Goals, but little is known about CHWs' efficacy in rural areas. METHODS: In this longitudinal prospective cohort study, almost all mothers giving birth (N = 470) in the Zithulele Hospital catchment area of the OR Tambo District were recruited and repeatedly assessed for 2 years after birth with 84.7-96% follow-up rates. During the cohort assessment we found that some mothers had received standard antenatal and HIV care (SC) (n = 313 mothers), while others had received SC, supplemented with home-visiting by CHWs before and after birth (HV) (n = 157 mothers, 37 CHWs). These visits were unrelated to the cohort study. Multiple linear and logistic regressions evaluated maternal comorbidities, maternal caretaking, and child development outcomes over time. RESULTS: Compared to mothers receiving SC, mothers who also received home visits by CHWs were more likely to attend the recommended four antenatal care visits, to exclusively breastfeed at 3 months, and were less likely to consult traditional healers at 3 months. Mothers in both groups were equally likely to secure the child grant, and infant growth and achievement of developmental milestones were similar over the first 2 years of life. CONCLUSION: CHW home visits resulted in better maternal caretaking, but did not have direct benefits for infants in the domains assessed. The South African Government is planning broad implementation of CHW programmes, and this study examines a comprehensive, home-visiting model in a rural region.
Assuntos
Saúde da Criança/estatística & dados numéricos , Agentes Comunitários de Saúde , Visita Domiciliar/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , Pré-Escolar , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez , Estudos Prospectivos , África do SulRESUMO
BACKGROUND: Adolescent motherhood has been repeatedly linked to poor child outcomes in high income countries and urban areas in low- and middle-income countries. We examine the structural, personal, and caretaking challenges of adolescent mothers and their children in rural South Africa compared to adult mothers over the first 24 months post-birth. METHODS: A cohort of sequential births (n = 470/493) in the rural OR Tambo District was recruited and reassessed at 3, 6, 9, 12, and at 24 months post-birth, with a retention rate above 84% at all timepoints. Maternal and child outcomes were examined over time using multiple linear and logistic regressions. RESULTS: Adolescent mothers reflect 17% of births (n = 76/458). Adolescent mothers were more likely to have water in their households, but less likely to live with a partner and to be seropositive for HIV than adult mothers. Risks posed by mental health symptoms, alcohol, and partner violence were similar. Adolescents exclusively breastfed for shorter time and it took longer for them to secure a child grant compared to adult mothers. Although obtaining immunizations was similar, growth was significantly slower for infants of adolescent mothers compared to adult mothers over time. CONCLUSIONS: In rural South Africa, almost one in five pregnant women is an adolescent. Caretaking tasks influencing child growth, especially breastfeeding and securing the child grant appear as the greatest problems for adolescent compared to adult mothers.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Desenvolvimento Infantil , Infecções por HIV/epidemiologia , Imunização/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Mães , Gravidez na Adolescência , Adolescente , Adulto , Pré-Escolar , Estudos de Coortes , Depressão Pós-Parto/epidemiologia , Características da Família , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Modelos Lineares , Modelos Logísticos , Estudos Longitudinais , Saúde Materna , Gravidez , Características de Residência/estatística & dados numéricos , População Rural , África do Sul/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
Young men in South Africa experience several adverse socio-structural and psychosocial factors that may contribute HIV risk behaviors. This study applied a syndemic framework to explore whether these syndemic factors are interconnected and work in synergy to increase HIV risk behaviors. Five syndemic factors were assessed including: binge drinking, polydrug use, depressive symptoms, violence and food insecurity on two HIV risk behaviors: multiple sex partners and transactional sex. Participants were (N = 1233) young men aged 18-29 years from a township in Cape Town, South Africa. Bivariate logistic regression analysis demonstrated that many of the syndemic factors were related to one another. Pairwise interactions (on an additive scale) among the syndemic factors revealed significant positive interactions between binge drinking and violence on greater odds of reporting multiple sex partners (aOR = 5.10, 95% CI 3.10, 8.29; p = < .001) compared to reporting neither factor. Also, food insecurity and violence (aOR = 2.89, 95% CI 1.63, 5.11; p = < .001) as well as food insecurity and polydrug use (aOR = 2.73, 95% CI 1.54, 4.84; p = < .001) were significantly associated with greater odds of transactional sex compared to reporting neither factor. Our findings highlight a synergistic relationship between some adverse socio-structural and psychosocial factors on HIV risk behaviors. HIV prevention programs that address multiple syndemic factors simultaneously may achieve greater impact on HIV risk reduction.
Assuntos
População Negra/psicologia , Depressão/epidemiologia , Abastecimento de Alimentos , Infecções por HIV/epidemiologia , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Violência/psicologia , Adolescente , Adulto , População Negra/estatística & dados numéricos , Depressão/psicologia , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Masculino , Fatores de Risco , Trabalho Sexual , Comportamento Sexual , Parceiros Sexuais , África do Sul/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sexo sem Proteção , Violência/estatística & dados numéricos , Adulto JovemRESUMO
Although mood congruity effects on episodic memory have been reported extensively in adults, they have not been reported for children younger than 10 years. The current research investigated mood congruity effects in story recall using an embodied approach to mood induction involving a facial manipulation task with 3- and 4-year-old children. Participants held a chopstick or a popsicle stick in their mouths in a way to either produce or inhibit a smile while they listened to a story featuring happy events for a happy character and sad events for a sad character. Children's mood ratings before and after mood induction indicated that mood became more positive in the smile condition, with no change in the no smile condition. Children in the smile condition, but not in the no smile condition, remembered more about the happy character than the sad character in the story. These results extend mood congruity effects to 3- and 4-year olds, suggesting that at this age representations of emotion interact with basic memory processes. Moreover, the efficacy of reenactment of sensorimotor components of emotion in modifying mood is consistent with embodied representation of emotion during early childhood.
Assuntos
Afeto/fisiologia , Desenvolvimento Infantil/fisiologia , Felicidade , Memória Episódica , Rememoração Mental/fisiologia , Sorriso/psicologia , Pré-Escolar , Feminino , Humanos , MasculinoAssuntos
Estudos Longitudinais , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Observacionais como AssuntoRESUMO
Intimate partner violence (IPV) is a common traumatic stressor for women worldwide, especially for women living in low-and-middle-income countries. One of the most common correlates of IPV victimization is alcohol use, but the dynamics of IPV and drinking among women are not well understood. Although some research suggests that women drink in the aftermath of IPV to cope with distress related to the violence they experienced, other studies imply that higher levels of alcohol use among one or both partners in a relationship make violence more likely. In this study, we examine this question in a secondary analysis of a longitudinal study of a population cohort of pregnant women in South Africa (N = 1238) using a Bayesian approach to latent growth curve structural equation modeling. Results indicate that on average, IPV decreases and alcohol use increases over time and that these trajectories are associated with each other. Further, results suggest that although IPV drives drinking (rather than the other way around), higher average levels of alcohol use are associated with a slower decrease in IPV. Findings have implications for future research on the association between IPV and alcohol use, as well as for clinical intervention for women who experienced IPV.
Assuntos
Violência por Parceiro Íntimo , Feminino , Humanos , Gravidez , África do Sul/epidemiologia , Estudos Longitudinais , Teorema de Bayes , Gestantes , Parceiros Sexuais , Fatores de RiscoRESUMO
BACKGROUND: Traumatizing events often result in long-term mental health symptoms. Identifying the features of the post-trauma experiences that can impact mental health symptoms is key to designing effective interventions. METHODS: Youth living with HIV (YLH),1 predominantly sexual and gender minorities (SGM;2 84 % gay, bisexual, transgender, queer, pansexual identities), 78 % Black and Latino, (N = 170) were recruited in New Orleans, LA and Los Angeles, CA from 13 youth-serving agencies. They were assessed for trauma, rumination and depression, with 78 % reassessed for depression at 4 and 74 % at 8 months later. Relationships between these variables were examined using a Bayesian approach to structural equation modeling. RESULTS: At recruitment, 78 % of YLH reported at least one traumatic event, and 21 % met the cut-off score indicating depression on the PHQ-9. Ruminations were reported by 41 % of YLH. While associations between trauma and depression were modest (rmean = 0.19), ruminations were moderately associated with depressive symptoms over time (rmean = 0.34). Ruminations were only modestly associated with trauma (rmean = 0.19) but had a robust negative association (λSTD = -0.29) with the slope of depressive symptoms such that the more ruminations YLH experienced, the smaller the decline in depression over time. The associations between trauma and depression were more modest (λSTD ≤ 0.12). Limitations The main limitations of this study are the lack of a scale to measure trauma and the use of a single item measure of rumination. CONCLUSION: Ruminations appear to be associated with traumatic events for a large subset of young people, suggesting that future interventions should consider including components addressing ruminations. CLINICALTRIALS: gov registration NCT03109431.
Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Adolescente , Humanos , Teorema de Bayes , Depressão/epidemiologia , Depressão/psicologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologiaRESUMO
The current study examines COVID-19 prevention behaviors and vaccine intentions among 83 youth at high risk for HIV. Most youth self-identified as Latinx (52%), cisgender men (84%), and homosexual (66%). Youth self-reported COVID-19 prevention behaviors and intentions to vaccinate. Participants reported wearing face masks, washing hands, and staying six feet apart, but fewer reported leaving home only for essential needs. About one-third reported that they would not get a vaccine, and lack of trust in their doctors and the government were significantly associated with non-intention. To improve efforts towards herd immunity, interventions to improve health messaging from trusted sources for at-risk youth may be necessary to achieve higher vaccine uptake.
Assuntos
COVID-19 , Infecções por HIV , Vacinas , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Intenção , Masculino , SARS-CoV-2 , Confiança , VacinaçãoRESUMO
BACKGROUND: While the negative impact of peri-natal depression is well-documented in high-income countries, the long-term effects across the life course in low and middle-income countries is less clear. Children's adjustment over the first five years is examined as a function of patterns of maternal depressed mood. METHODS: Pregnant women in 24 peri-urban townships (N = 1,238) were randomized to a home-visiting intervention or standard care and reassessed five times, with high retention. There were no intervention effects on children past 18 months. Multilevel regression models examined the impact of depressed mood on child outcomes. Using the Edinburgh Postnatal Depression Scale, four patterns of maternal depressed mood were identified: never (40.6%); antenatal (13.0%); early childhood (26.1%); and recurrent episodes of depressed mood (20.3 %). FINDINGS: Mothers' patterns of depressive symptoms and child outcomes were similar, regardless of intervention. Never depressed mothers were significantly younger, had higher income, less food insecurity, were more likely to have electricity, be living with HIV or have an HIV positive partner, and had fewer problems with alcohol than depressed mothers. Children of mothers who experienced depressed mood weighed less, were more aggressive, and were hospitalized more often than children of never depressed mothers, but were similar in cognitive and social development. INTERPRETATIONS: Depressed mood, has significant negative impacts on South African children's growth and aggressive behavior. The timing of maternal depressed mood was less important than never having a depressed mood or a recurrent depressed mood. FUNDING: There were no funding conflicts in executing this trial.
Assuntos
Desenvolvimento Infantil , Depressão , Criança , Pré-Escolar , Depressão/epidemiologia , Feminino , Visita Domiciliar , Humanos , Mães , Gravidez , África do Sul/epidemiologiaRESUMO
OBJECTIVE: To examine whether maternal depressed mood at birth moderated the protective effect of a home-visiting intervention on the quality of caregiving for children growing up in a low- and middle-income country. METHOD: Almost all pregnant mothers in 24 Cape Town neighborhoods were recruited into a cluster randomized controlled trial matched by neighborhoods to the Philani home-visiting condition (HVC) or the standard care condition (SC). At 3 years after birth, the quality of mother-child interactions between HVC and SC mothers with and without antenatal depressed mood was assessed in a representative subset by rating videotaped observations of mother-child interactions on 10 dimensions of caregiving. RESULTS: As predicted, maternal depressed mood at birth moderated the effect of the HVC on the quality of mother-child interactions. Among nondepressed mothers, mothers and their children in the HVC scored significantly higher on 5 of the 10 dimensions of the maternal-child interaction scale than mothers in the SC: mothers exhibited more maternal sensitivity, talked more, had more harmonious interactions, and had children who paid more attention and exhibited more positive affect. However, being in the HVC did not significantly affect the mother-child interaction scores among mothers with depressed mood. Among HVC children, those with mothers with depressed mood showed significantly less positive affect and talked less with their mothers than children with nondepressed mothers. SC children with mothers with depressed mood were more responsive and paid attention to their mothers than children with nondepressed mothers. CONCLUSION: Home visiting resulted in a better quality of caregiving for mothers without depressive symptoms. Future interventions need to specifically target maternal depression and positive mother-child interactions. CLINICAL TRIAL REGISTRATION INFORMATION: Mentor Mothers: A Sustainable Family Intervention in South African Townships; https://clinicaltrials.gov; NCT00972699; Philani Home-based Nutrition Intervention Program; https://clinicaltrials.gov; NCT00995592.
Assuntos
Depressão/psicologia , Visita Domiciliar , Relações Mãe-Filho , Mães/psicologia , Complicações na Gravidez/psicologia , Adulto , Criança , Desenvolvimento Infantil , Saúde da Criança , Agentes Comunitários de Saúde , Depressão/epidemiologia , Feminino , Humanos , Saúde Materna , Avaliação de Resultados em Cuidados de Saúde , Período Pós-Parto/psicologia , Gravidez , Cuidado Pré-Natal , Efeitos Tardios da Exposição Pré-Natal , África do SulRESUMO
OBJECTIVE: This study examines the effect of a home visiting intervention on maternal alcohol use, problematic drinking, and the association of home visiting and alcohol use on children's behavioral, cognitive, and health outcomes at 5 time points over 5 years. METHOD: We analyzed 5,099 observations of 1,236 mothers and their children from pregnancy to 5 years postbirth, within a longitudinal cluster-randomized trial evaluating the effect of a home visiting intervention on mothers in Cape Town, South Africa. Paraprofessional home visitors coached mothers on coping with multiple risk factors, including a brief, 1-visit intervention on alcohol prevention in pregnancy. We assessed changes in maternal drinking over time in relation to the intervention, and then examined the impact of these drinking patterns on child outcomes over five years. RESULTS: Drinking increased over the 5 years postbirth, but it was significantly lower in the intervention condition. Compared with abstinence, mothers' problematic drinking was associated with decreased child weight (-0.21 z-units) at all assessments, increased child aggressive behavior (3 to 7 additional symptoms), and decreased child performance on an executive functioning measure (the silly sounds task; odds ratio = .34) at 3 and 5 years. The intervention's effect was associated with increased child aggression (0.25 to 0.75 of 1 additional symptom), but the intervention appeared to decrease the effect of problem drinking on children's aggressive acts and executive functioning. CONCLUSION: These findings support the need for sustained interventions to reduce alcohol use, especially for mothers who exhibit problematic drinking. Maternal drinking influences children's health and development over time. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Deficiências do Desenvolvimento/epidemiologia , Visita Domiciliar/estatística & dados numéricos , Mães/estatística & dados numéricos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adulto , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Gravidez , África do Sul/epidemiologiaRESUMO
AIMS: To examine child outcomes over time among mothers with perinatally depressed mood in rural South Africa (SA). METHODS: A representative sample of consecutive births (470/493) in the OR Tambo District of the Eastern Cape of South Africa (SA) were recruited and were reassessed at five points over the course of the next two years: 85% were reassessed at 3 months, 92% at 6 months, 88% at 9 months, 91% at 12 months, and 88% at 2 years post-birth. Over time, the children of mothers with perinatally depressed mood (16%) were compared to children of mothers without depressed mood using multiple linear and logistic regressions. RESULTS: Mothers with perinatal depressed mood are significantly less likely to live with the child's father or their in-laws (23% vs 35%), have household incomes above 2000 ZAR (154 USD) (31% vs 51%), and significantly more likely to have experienced IPV prior (19% vs 9%) and during (32% vs 20%) pregnancy compared to mothers without depressed mood. There are no differences in age, education, primipara, HIV status (29% seropositive), or alcohol use. Growth and developmental delays and motor and speech milestones through 24 months post-birth are similar for mothers with and without perinatal depressed mood. CONCLUSIONS: Despite increased economic and partner difficulties associated with perinatal depressed mood, infant outcomes are similar in mothers with and without depressed mood in rural South Africa.
Assuntos
Depressão/psicologia , Mães/psicologia , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/psicologia , Parceiros Sexuais/psicologia , África do Sul/epidemiologiaRESUMO
To better understand acceptability of long-acting injectable antiretroviral treatment (LAI-ART) regimens for HIV management, we conducted seven semi-structured focus group discussions with experienced HIV care providers and persons living with HIV (PLWH) and five individual interviews with parents of children living with HIV in the western United States. Although providers were wary about a potential negative impact on consistent engagement in care, they predicted that patients, especially those with adherence challenges, would be enthusiastic about LAI options. Many PLWH, especially young adults, welcomed the option of an LAI-ART regimen; however, others feared injections and expressed concerns about possible side effects, dosing more frequent than every 2 weeks, additional costs, and lower efficacy. Parents' interest varied according to their child's age and sensitivity to injections. In summary, potential users considered LAI-ART generally acceptable yet voiced possible concerns as well, especially if their current pill-based regimen was effective in achieving viral suppression.