The causes and consequences of HIV-related enacted and internalized stigma: a comment on Takada et al.

摘要

The magnitude of stress and associated health consequences experienced by caregivers compromises their ability to effectively provide care to children, especially children with disability. We used latent class analysis of data from the 2010 Ohio Family Health Survey and identified 3 distinct classes of caregivers based on patterns of responses to 15 financial and psychological stresses they experienced. Compared with children residing in households in which caregivers experienced very little or no stress, children with disability were twice as likely to reside with caregivers with high levels of financial stress and almost 3.5 times as likely to reside with caregivers with high levels of financial stress and very high levels of psychological stress than typically developing children. Reducing caregiver stress is a critical step to ensuring the best health outcomes possible for children with disability. We identify the heterogeneity that is present in the population of caregivers by virtue of patterns of responses to various financial and psychological stressors. Children with disability are more likely to live in households in which a greater number of stressors affect caregivers. Different confounders are also associated with the latent classes of stress we identify. This is an important implication when determining the right interventions to target to the right subpopulations.