Coping Styles as Predictors of Medication Adherence in Inner-City Adolescents Inf

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DESCRIPTION (provided by applicant): The increase of HIV infected adolescents in the United States is a significant problem, especially in urban areas. Youth who test positive for HIV are often confronted with a variety of difficulties as they struggle to proceed through life while carrying the burden of a highly stigmatized and life-threatening illness. Most studies investigating adherence in HIV-infected adolescents and young adults have found management of their HIV disease to be a lesser of their life priorities with rates of noncompliance ranging from 37% to 70%. Despite the existence of effective antiretroviral therapy, nonadherence leads to diminished health outcomes in approximately half of the patients for whom it is prescribed. This issue presents a considerable challenge to treatment and results in significant public health implications. The candidate is a psychologist specializing in work with adolescents and young adults at the University of Maryland, Baltimore (UMB) who has conducted preliminary research with HIV-infected youth. The training phase of the award will consists of five primary activities: 1) to learn the essential principles of infectious disease and clinical epidemiology, 2) to develop further skills in study design and implementation of public health and behavioral research, 3) to develop advanced skills in biostatistical analysis; 4) to develop skills in the responsible conduct of research, and 5) to refine skills in presenting, publishing, and grant writing. The research phase will investigate whether the coping styles of inner city youth infected with HIV (IYH) can predict their adherence to care by designing and implementing an innovative study. Using primary data collection and analysis, Aim1 of this study will determine the relationship between maladaptive coping and adherence to care in IYH. Aim 2 will explore how coping styles among IHY differ according to mode of transmission, gender, ethnicity, or age. This proposed study will lead to future clinical trials on interventions of developmentally appropriate, adolescent-specific strategies to foster sustained HIV care and medication adherence. Upon completion of this award, the candidate will become a rigorous behavioral scientist informed by his clinical orientation and able to discover empirically-driven solutions to public health problems.