Predictors of ART Adherence for Behaviorally-Infected HIV+ African-American Males

描述(申请人提供)：艾滋病毒/艾滋病疫情在过去30年里影响了全世界数百万人。虽然目前还没有治愈艾滋病毒/艾滋病的方法，但在治疗艾滋病毒/艾滋病方面取得了重大的药理学进展，大大延长了患有这种疾病的人的预期寿命和生活质量。具体地说，自1996年以来，抗逆转录病毒(ARV)药物一直是美国护理的标准，减少体内艾滋病毒病毒颗粒的产生，以及恢复 宿主的免疫功能。然而，为了使抗逆转录病毒药物(ARV)有效，需要近100%的药物剂量依从率。青少年和来自种族/少数民族背景的个人已被记录为遵守抗逆转录病毒药物的情况很差。尽管之前的研究已经确认精神疾病和药物滥用是抗逆转录病毒治疗依从性的有力预测因素，但很少有研究考察年轻成年人和青少年非裔美国男性坚持抗逆转录病毒治疗的预测因素，这是一个艾滋病毒感染和抗逆转录病毒药物不依从性都很高的人口群体。Oda将允许在不增加误差的情况下，在过多的人口、心理社会和生物医学数据中确定遵守的最强预测因素。此外，将创建一个分类树分析模型，突出非裔美国男性在行为上感染艾滋病毒的坚持和不坚持的途径。

DESCRIPTION (provided by applicant): The HIV/AIDS epidemic has affected millions of individuals worldwide over the past 30 years. Although there is currently no cure for HIV/AIDS, significant pharmacological advances in the treatment of HIV/AIDS have been developed, which has greatly extended the life expectancy and quality of life for individuals living with the diseas. Specifically, since 1996 antiretroviral (ARV) medication has been the standard of care in the United States, reducing the production of HIV viral particles in the body, as well as restoring the host body's immunological functioning. However, in order for (ARV) medication to be effective, a nearly 100% medication dose adherence rate is required. Individuals infected with HIV/AIDS on ARV medication regimens who are not adherent pose a significant public health risk as they are (a) at greater risk for disease progression; (b) more likely to be resistant to ARV medication treatment in the future; and (c) are more likely to transmit the virus to the general public, as wel as transmit mutated strains of the disease, which have a poorer response to ARV treatment. Adolescents and individuals from racial/ethnic minority backgrounds have been documented to have poor ARV adherence. Although prior studies have identified psychiatric illness and substance abuse to be strong predictors of ARV adherence, there is little research that examines the predictors of adherence among young adult and adolescent African American males, a demographic group at great risk for both HIV infection and ARV non-adherence. Therefore the objectives of the current study are to (a) identify the strongest predictors of ART adherence among African American adolescent and young adult males (<24 years) behaviorally infected with HIV; (b) to create a classification tree analysis model of adherence that maximizes classification accuracy for adherence and non-adherence; and (c) to identify the protective and risk factors that can be incorporated into intervention and prevention programs that increase ARV adherence. For the purpose of this study, a subsample of 790 African American males (<24 years) behaviorally-infected with HIV, who participated in the Adolescent Trials Network for HIV/AIDS Interventions (ATN) 086 protocol in 2010-2011, will be investigated using an exploratory multivariate analysis technique known as Optimal Data Analysis (ODA). ODA will allow the identification of the strongest predictor of adherence among a plethora of demographic, psychosocial, and biomedical data without increasing error. In addition, a classification tree analysis model will be created highlighting the pathways to adherence and non-adherence among African American males behaviorally-infected with HIV.