Medication Adherence Among HIV+ Hispanics

描述（由申请人提供）：职业发展计划：申请人正在申请5年的资助，通过指导患者导向的研究职业发展奖（K23-PA-05-143），将她发展成为艾滋病毒/艾滋病健康差异研究的独立研究者，重点研究艾滋病毒+西班牙裔患者抗逆转录病毒治疗的社会文化方面和生物学结果。职业发展方法：提出了一个协调的、有指导的教学、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；将完成社会文化和依从性研究、艾滋病毒/艾滋病生物学成果、高级研究方法、生物统计学和流行病学以及研究伦理行为方面的正式课程和培训；并参加相关地方研讨会和全国性科学会议。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/艾滋病流行和无数社会风险因素的影响不成比例。然而，关于社会文化因素如何影响这一群体的抗逆转录病毒依从性，我们知之甚少。这项拟议的研究将使用电子药物监测技术，在艾滋病毒阳性的西班牙裔和非西班牙裔白人成人样本中检验抗逆转录病毒依从性的社会文化决定因素。具体研究目的：1)确定社会文化因素是否单独与HIV+西班牙裔患者抗逆转录病毒依从性和生物学结局相关；2)在考虑社会风险因素的影响后，评估培养对抗逆转录病毒依从性和生物学结局的影响；3)研究社会文化“危险因素”是否介导种族对抗逆转录病毒依从性的影响，并明确研究神经心理（NP）功能在这种关联中的作用。研究方法：Rivera Mindt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名非西班牙裔白人成年人进行抗逆转录病毒依从性研究。意义：本研究将增强我们对艾滋病毒+西班牙裔患者抗逆转录病毒依从性的理解，并导致创新的、有文化针对性的干预措施，以提高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史上服务不足的群体中抗逆转录病毒依从性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.