Mental Health and Risk in HIV+ Youth and Seroreverters

艾滋病毒青年和血清逆转者的心理健康和风险

• 批准号: 6834597
• 负责人: Claude Ann Mellins
• 金额: $ 73.48万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-12-11 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6834597
• 关键词: HIV infections; adolescence (12-20); behavioral /social science research tag; child behavior; child mental disorders; child psychology; clinical research; disease /disorder proneness /risk; family structure /dynamics; health care service utilization; high risk behavior /lifestyle; human subject; interview; longitudinal human study; mental health epidemiology; middle childhood (6-11); motivation; sex behavior; social support network; substance abuse related disorder; therapy compliance

DESCRIPTION (provided by applicant): The goals of the proposed five year study are to 1) determine the prevalence of Psychiatric Disorders and Behavioral Health Outcomes, including emotional and behavioral functioning, HIV risk behaviors, and adherence to medication in perinatally HIV-infected adolescents; 2) examine the association between HIV infection and Psychiatric Disorders and Behavioral Health Outcomes by comparing perinatally HIV-infected youth to uninfected youth exposed to HIV in utero (seroreverters); and 3) identify risk and protective factors related to Behavioral Health Outcomes in both groups prospectively over 18 months. To achieve the study goals, we will conduct a five year, longitudinal study of 200 perinatally HIV-infected children and 150 seroreverters, ages 9 - 16 years, residing in NYC, one of the epicenters of the HIV epidemic among women and children in the US. The proposed sample of 700 participants will consist of the child (n = 350) and his/her primary caregiver (n = 350). Two sources of data will be used: 1) caregiver and child interviews and 2) medical chart abstraction (lymphocyte subsets, HIV RNA viral load, CDC diagnosis, antiretroviral treatment, medical service utilization). Each participant will be individually interviewed at baseline and 18-month follow-up. The interview, guided by Social Action Theory, will assess Psychiatric Disorders, Behavioral Health Outcomes, and a range of determinants of Behavioral Health Outcomes. These determinants consist of the individual's self-regulation processes and the larger social, family, individual, and environmental context. In the proposed study, we emphasize the importance of the child's HIV status and psychiatric functioning as well as family factors (communication, supervision, and involvement) in influencing Behavioral Health Outcomes. Participants will be recruited from four major medical centers in NYC, each of which provides comprehensive medical and mental health care to HIV-infected children and seroreverters. Reflecting the pediatric HIV epidemic, the patients in these clinics are primarily African American and Latino, living in poverty in inner-city communities, with high HIV seroprevalence and rates of drug use. The proposed study will inform us about the specific stressors and correlates of mental health problems, as well as HIV risk behavior in this population. Thus, it will be a critical step in the development of effective interventions for a population that is fast emerging as a new risk group both in the US and in developing countries with 'limited access to treatment and other resources.

描述（由申请人提供）：拟议的五年研究的目标是 1) 确定精神疾病的患病率和行为健康结果，包括情绪和行为功能、艾滋病毒风险行为以及围产期艾滋病毒感染青少年的药物依从性； 2) 通过比较围产期感染艾滋病毒的青少年与子宫内暴露于艾滋病毒的未感染青少年（血清逆转者），检查艾滋病毒感染与精神疾病和行为健康结果之间的关联； 3) 前瞻性地确定 18 个月内与两组行为健康结果相关的风险和保护因素。为了实现研究目标，我们将对居住在美国妇女和儿童艾滋病毒流行中心之一纽约市的 200 名围产期 HIV 感染儿童和 150 名年龄在 9 至 16 岁的血清逆转者进行为期五年的纵向研究。拟议的 700 名参与者样本将包括儿童 (n = 350) 及其主要照顾者 (n = 350)。将使用两个数据源：1) 护理人员和儿童访谈；2) 医学图表摘要（淋巴细胞亚群、HIV RNA 病毒载量、CDC 诊断、抗逆转录病毒治疗、医疗服务利用）。每个参与者都将在基线和 18 个月的随访中接受单独访谈。该访谈以社会行动理论为指导，将评估精神疾病、行为健康结果以及行为健康结果的一系列决定因素。这些决定因素包括个人的自我调节过程以及更大的社会、家庭、个人和环境背景。在拟议的研究中，我们强调儿童的艾滋病毒状况和精神功能以及家庭因素（沟通、监督和参与）对影响行为健康结果的重要性。参与者将从纽约市的四个主要医疗中心招募，每个中心都为艾滋病毒感染儿童和血清逆转者提供全面的医疗和心理保健服务。这些诊所的患者主要是非裔美国人和拉丁裔，生活在市中心社区的贫困中，艾滋病毒血清流行率和吸毒率都很高，这反映了儿科艾滋病毒的流行情况。拟议的研究将告诉我们特定的压力源和心理健康问题的相关性，以及该人群的艾滋病毒危险行为。因此，对于在美国和发展中国家“获得治疗和其他资源的机会有限”的正在迅速成为新风险群体的人群，这将是制定有效干预措施的关键一步。