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

描述（由申请人提供）：美国青少年艾滋病毒感染人数的增加是一个重大问题，尤其是在城市地区。艾滋病毒检测呈阳性的青年往往面临各种各样的困难，因为他们在生活中挣扎着，同时背负着一种高度耻辱和危及生命的疾病的负担。大多数调查艾滋病毒感染青少年和青壮年依从性的研究发现，对艾滋病毒疾病的管理在他们的生活优先事项中所占的比例较低，不依从性的比例从37%到70%不等。尽管存在有效的抗逆转录病毒疗法，但不坚持治疗导致约一半接受治疗的患者健康状况下降。这一问题对治疗提出了相当大的挑战，并造成重大的公共卫生影响。候选人是马里兰大学巴尔的摩分校（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青少年进行了初步研究。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则；2)进一步发展公共卫生和行为研究的研究设计和实施技能；3)发展生物统计分析的高级技能；4)培养负责任的研究行为的技能，5)完善演讲、出版和拨款写作的技能。研究阶段将通过设计和实施一项创新研究来调查内城青少年感染艾滋病毒（IYH）的应对方式是否可以预测他们对护理的依从性。通过对原始数据的收集和分析，本研究的目的1将确定青春期青少年的适应不良应对与护理依从性之间的关系。目标2将探讨IHY的应对方式如何根据传播方式、性别、种族或年龄而有所不同。这项拟议的研究将导致未来的临床试验，以发展适当的干预措施，青少年特定的策略，以促进持续的艾滋病护理和药物依从性。完成该奖项后，候选人将成为一名严谨的行为科学家，他的临床方向和能够发现经验驱动的解决方案，以公共卫生问题。

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.