Cumulative lifetime adversity and social support were investigated as determinants of psychosocial adjustment (esteem, distress, hopefulness, positive outlook/future aspirations, and sense of purpose) over 12 months in 6-10-years-old HIV-infected, HIV-exposed uninfected and HIV-unexposed uninfected children from Uganda. Each determinant and psychosocial adjustment indicator was self-reported using standardized questionnaires administered at baseline, 6, and 12 months. Linear mixed effects models were used to relate time-varying lifetime adversity and social support to psychosocial adjustment over 12 months. Regardless of HIV status, higher adversity predicted lower esteem (coefficient b = -2.98, 95% confidence interval (CI): [-4.62, -1.35]) and increased distress (b =3.96, 95% CI: [1.29, 6.62]) but was not associated with hopefulness, positive outlook or sense of purpose. Low social support predicted higher distress (b =9.05, 95% CI: [7.36, 10.73]), lower positive outlook (b = -10.56, 95% CI: [-2.34, -8.79]) and low sense of purpose (b = -9.90, 95% CI: [-11.44, -8.36]) over 12 months. Pragmatic interventions that enhance coping with adversity and provide emotional/instrumental support should be tested for effectiveness in promoting resilient psychosocial adjustment trajectory in vulnerable children.

中文翻译：

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乌干达儿童的心理社会适应：应对人类免疫缺陷病毒暴露，终生逆境和社会支持的重要性

在6到10岁的HIV感染者，未暴露HIV的12个月内，调查了累积的终生逆境和社会支持作为决定心理社会适应能力（自尊，痛苦，希望，积极的看法/未来抱负和目标感）的决定因素以及乌干达未接触艾滋病毒的未感染儿童。每个决定因素和社会心理适应指标均使用基线，第6和第12个月时使用的标准化问卷进行自我报告。使用线性混合效应模型将时变的终生逆境和社会支持与12个月内的社会心理调整联系起来。不论艾滋病毒感染状况如何，较高的逆境预示着较低的自尊心（系数b = -2.98，95％置信区间（CI）：[-4.62，-1.35]）和困扰增加（b = 3.96，95％CI：[1.29，6.62]） ），但与希望无关，积极的看法或目标感。低的社会支持率会带来更大的困扰（b = 9.05，95％CI：[7.36，10.73]），较低的积极前景（b = -10.56，95％CI：[-2.34，-8.79]）和低目标感（b = -9.90，95％CI：[-11.44，-8.36]），超过12个月。应测试能增强应对逆境能力并提供情感/工具支持的务实干预措施，以促进弱势儿童适应性强的心理社会适应轨迹。