Neuropsychological and cultural predictors of adherence

描述（由申请人提供）：西班牙裔社区的艾滋病毒感染与美国总人口不成比例（CDC, 2002）。西班牙裔占美国人口的13%，但他们占美国报告的艾滋病病例的20% （CDC, 2002）。与非西班牙裔白人相比，西班牙裔的新感染率约为四倍，与非西班牙裔白人相比，估计西班牙裔感染艾滋病毒/艾滋病的人数为25%至12% （CDC， 2002年）。许多研究已经确定了艾滋病毒感染的有害神经认知后遗症和功能影响，研究表明少数民族不太可能遵守医疗协议。针对HIV/AIDS的高效抗逆转录病毒疗法（HAART）有助于抑制HIV参与中枢神经系统的有害神经认知效应。然而，为了从高效抗逆转录病毒疗法中获益，个人必须警惕自己的依从性。研究表明，神经心理（NP）损伤的个体不太可能坚持他们的药物治疗方案。然而，这些研究主要调查了非裔美国人，没有强调文化差异。由于拉美裔人的艾滋病毒感染率不成比例，拉美裔人的新感染率很高，而且有不遵守医疗规程的风险，这一群体出现神经认知障碍和日常活动功能受损的风险特别高。本研究旨在通过在艾滋病毒阳性的西班牙裔和人口统计学上匹配的非西班牙裔白人成人样本中检验NP和文化因素对药物依从性的预测来扩展文献。该研究的目的是：i)利用最先进的药物监测技术表征HIV+西班牙裔成年人的药物依从率，并将该群体的药物依从率与人口统计学和医学上匹配的非西班牙裔白人样本进行比较；2)确定最能预测药物依从性的神经心理学领域；3)评估文化适应在HIV+西班牙裔患者服药依从性中的作用。这项研究，如果得到资助，对公共卫生具有特别重要的意义，因为对西班牙裔药物服用行为有一个清晰的了解，可以帮助制定针对西班牙裔NP障碍和文化问题的量身定制的干预措施，并有望减轻艾滋病毒对该社区的不成比例的影响。

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.