Neuropsychological and cultural predictors of adherence

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): HIV infection among the Hispanic community is disproportionate to the overall population of the United States (CDC, 2002). Hispanics account for 13% of the U.S. population, yet they account for 20% of reported AIDS cases in the U.S. (CDC, 2002). Hispanics have approximately four tunes the rate of new infections compared to non-Hispanic Whites, and the estimated number of Hispanics living with HIV/AIDS compared to non-Hispanic Whites is 25% to 12% (CDC, 2002). Numerous studies have identified the detrimental neurocognitive sequela and functional impact of HIV infection and research has shown that ethnic minorities are less likely to adhere to medical protocols. Highly active antiretroviral therapy (HAART) for HIV/AIDS has helped to inhibit the detrimental neurocognitive effects of HIV's involvement in the central nervous system. However, in order to benefit from HAART, individuals must be vigilant in their compliance. Studies have shown that individuals with neuropsychological (NP) impairment are less likely to adhere to their medication regimens. However, these studies have examined mostly African American populations, with no emphasis on cultural differences. With disproportionate rates of HIV infection among Hispanics, the high rate of new infections among Hispanics, and the risk of not adhering to medical protocols, this group is at particularly high risk for neurocognitive impairment and impaired functioning in everyday activities. The present study intends to extend the literature by examining the NP and cultural predictors of medication adherence in a sample of HIV+ Hispanic and demographically matched non-Hispanic white adults. The aims of the study are to: i) characterize HIV+ Hispanic adults' medication adherence rates using state of the art medication monitoring technology, and compare this groups' medication adherence rates to a demographically and medically matched sample non-Hispanic whites; 2) Determine the neuropsychological domains most predictive of medication adherence; and 3) Evaluate the role acculturation plays in medication adherence among HIV+ Hispanics. This study, if funded, has particular import on public health, as developing a clear understanding of Hispanics' medication taking behaviors can help develop tailored interventions targeting NP impairment and cultural issues for Hispanics and hopefully attenuate HIV's disproportionate impact on this community.