Caregiver's and child's self-reported quality of life (QOL) was defined using standardized questionnaires in a sample (N = 277) of 6-10 years old HIV-infected, HIV-exposed uninfected, and HIV-unexposed uninfected children from Uganda. Psychosocial stress (acute stress and cumulative lifetime adversity) and physiologic stress (dysregulations across 13 biomarkers), perinatal HIV status, and their interaction were related to child QOL via general linear models. Lower child- and caregiver-reported psychosocial stress were dose-dependently associated with higher QOL (acute stress: mean difference coefficient b = 8.1-14.8, effect size [ES] = 0.46-0.83). Lower allostasis was dose-dependently associated with higher QOL (b = 6.1-9.7, ES = 0.34-0.54). Given low caregiver acute stress, QOL for HIV-infected was similar to HIV-uninfected children; however, given high caregiver acute stress, a QOL disadvantage (b = -7.8, 95% CI: -12.8, -2.8; ES = -0.73) was evident for HIV-infected versus uninfected children. Testing of caregiver stress reduction interventions is warranted to increase wellbeing in dependent children.

中文翻译：

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有和没有围产期人免疫缺陷病毒感染的学龄前乌干达儿童的毒性应激和生活质量

在乌干达6-10岁的HIV感染，未暴露HIV感染和未暴露HIV的未感染儿童中，使用标准化调查表（N = 277）定义了看护者和孩子的自我报告的生活质量（QOL）。通过通用线性模型，社会心理压力（急性压力和终生累积逆境）和生理压力（13种生物标志物的调节异常），围产期HIV状况及其相互作用与儿童生活质量有关。较低的儿童和照顾者报告的社会心理压力与较高的生活质量有剂量依赖性（急性压力：平均差异系数b = 8.1-14.8，影响大小[ES] = 0.46-0.83）。较低的同种异体症与较高的QOL呈剂量依赖性（b = 6.1-9.7，ES = 0.34-0.54）。由于照顾者的急性压力低，艾滋病毒感染者的生活质量类似于未感染艾滋病毒的儿童。但是，鉴于照顾者的急性应激反应非常严重，HIV感染儿童和未感染儿童的QOL不利（b = -7.8，95％CI：-12.8，-2.8； ES = -0.73）。测试照护者减少压力的干预措施可以增加抚养儿童的幸福感。