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

描述(由申请人提供)：在美国，感染艾滋病毒的青少年的增加是一个严重的问题，特别是在城市地区。艾滋病毒检测呈阳性的年轻人经常面临各种困难，因为他们背负着高度耻辱和危及生命的疾病的负担，艰难地度过一生。大多数调查艾滋病毒感染青少年和年轻人遵守情况的研究发现，对艾滋病毒疾病的管理在他们生活中的优先事项中占较小的比例，不遵从率从37%到70%不等。尽管存在有效的抗逆转录病毒治疗，但不坚持治疗会导致约一半开出抗逆转录病毒治疗的患者的健康结局下降。这一问题对治疗提出了相当大的挑战，并对公共卫生产生了重大影响。候选人是巴尔的摩马里兰大学(UMB)专门从事青少年和年轻人工作的心理学家，他对感染艾滋病毒的年轻人进行了初步研究。该奖项的培训阶段将包括五项主要活动：1)学习传染病和临床流行病学的基本原理，2)发展公共卫生和行为研究的研究设计和实施方面的进一步技能，3)发展生物统计分析方面的高级技能，4)发展负责任的研究进行技能，5)完善陈述、出版和拨款撰写的技能。研究阶段将通过设计和实施一项创新研究，调查感染艾滋病毒(IYH)的市中心青年的应对方式是否可以预测他们对护理的坚持。通过初步数据收集和分析，本研究的Aim1将确定IYH患者的适应不良应对与坚持护理之间的关系。目标2将探索不同传播方式、性别、种族或年龄的IHY应对方式的差异。这项拟议的研究将导致未来的临床试验，以干预适合发育的、针对青少年的战略，以促进持续的艾滋病毒护理和药物依从性。完成这一奖项后，候选人将成为一名严格的行为科学家，他的临床取向为他所知，并能够发现公共卫生问题的经验驱动的解决方案。

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.