Medication Adherence Among HIV+ Hispanics

职业发展计划：申请人正在申请5年的资金，通过指导患者为导向的研究职业发展奖（K23-PA-05-143），以发展她成为艾滋病毒/艾滋病健康差异研究的独立调查员，重点是调查抗逆转录病毒依从性的社会文化方面和艾滋病毒+西班牙裔的生物学结果。职业发展方法：提出了一个协调的，指导性的教学和研究培训和学习发展课程。里维拉明特博士将接受导师的指导;将完成社会文化和坚持研究、艾滋病毒/艾滋病生物学成果、先进研究方法、生物统计学和流行病学以及研究的道德行为方面的正式课程和培训;并参加相关的地方研讨会和国家科学会议。科学背景：西班牙裔社区是美国最大和增长最快的种族/少数民族群体，受艾滋病毒/艾滋病流行病和无数社会风险因素的影响尤为严重。然而，鲜为人知的是，社会文化因素如何影响抗逆转录病毒治疗坚持在这一组。这项拟议的研究将使用电子药物监测技术，在艾滋病毒阳性西班牙裔和非西班牙裔白色成年人样本中检查抗逆转录病毒治疗依从性的社会文化决定因素。具体研究目标：1）确定社会文化因素是否与HIV+西班牙裔人的抗逆转录病毒依从性和生物学结局单独相关; 2）在考虑社会风险因素的影响后，评估文化对抗逆转录病毒依从性和生物学结局的影响;以及3）检查社会文化“风险因素”是否介导种族对抗逆转录病毒治疗依从性的影响，并明确检查在这种关联中神经心理（NP）功能的影响。研究方法：里维拉明特博士将领导一项利用先进的电子药物监测技术对100名艾滋病毒阳性西班牙裔和50名非西班牙裔白色成年人进行抗逆转录病毒依从性研究。重要性：这项研究将提高我们对艾滋病毒+西班牙裔人抗逆转录病毒依从性的理解，并导致创新的，文化上量身定制的干预措施，以增加这一群体的抗逆转录病毒依从性。该项目还将导致对这一历来得不到充分服务的群体坚持抗逆转录病毒治疗的社会文化因素进行更大规模的纵向研究。

DESCRIPTION (provided by applicant): Career Development Plan: The applicant is requesting 5 years of funding through the Mentored Patient- Oriented Research Career Development Award (K23-PA-05-143) to develop her into an independent investigator in HIV/AIDS health disparities research, with an emphasis on investigating the sociocultural aspects of antiretroviral adherence and biologic outcomes with HIV+ Hispanics. Career Development Methods: A coordinated, mentored curriculum of didactic and research training and study development is proposed. Dr. Rivera Mindt will receive guidance from her mentors; will complete formal coursework and training in sociocultural and adherence research, HIV/AIDS biologic outcomes, advanced research methodology, biostatistics and epidemiology, and the ethical conduct of research; and participate in related local seminars and national scientific meetings. Scientific Background: The Hispanic community is the largest and fastest growing racial/ethnic minority group in the U.S., and is disproportionately affected by the HIV/AIDS epidemic and myriad social risk factors. However, little is known regarding how sociocultural factors impact antiretroviral adherence in this group. The proposed study will examine the sociocultural determinants of antiretroviral adherence in a sample of HIV+ Hispanic and non-Hispanic white adults using electronic medication monitoring technology. Specific Research Aims: 1) To determine whether sociocultural factors are individually associated with antiretroviral adherence and biological outcomes among HIV+ Hispanics; 2) To evaluate the impact of culture on antiretroviral adherence and biological outcomes, after accounting for the impact of social risk factors; and 3) To examine whether sociocultural "risk factors" mediate the effect of ethnicity on antiretroviral adherence, and to examine explicitly the effects of neuropsychological (NP) functioning in this association. Research Methods: Dr. Rivera Mindt will lead a study of antiretroviral adherence utilizing advanced, electronic medication monitoring technology for 100 HIV+ Hispanic and 50 non-Hispanic white adults. Significance: This study will enhance our understanding of antiretroviral adherence among HIV+ Hispanics & lead to innovative, culturally tailored interventions to increase antiretroviral adherence in this group. This project will also lead to a larger-scale, longitudinal study of sociocultural factors in antiretroviral adherence among this historically under-served group.