Emotion regulation, ART adherence, and virologic status among adolescents and young adults living with HIV in Zambia

项目总结/摘要 背景：赞比亚近三分之二的青少年和青年艾滋病毒感染者（AYALHIV） 病毒学失败到目前为止，有限的研究已经评估了发展因素在实现积极发展中的作用。 艾滋病自我管理行为和良好的健康结果AYALHIV。全面 了解这些因素对于应对这一高度优先人群中的艾滋病毒流行至关重要。 研究目标和目的：利用父母研究来测试AYALHIV照顾者的家庭关系 在赞比亚的干预措施中，拟议的研究将验证和评估青少年发展的措施， - 情绪调节-与病毒学失败，ART坚持，家庭和社会因素有关。具体 目的是：1）在赞比亚的AYALHIV中评估情绪调节困难量表（DERS-SF）; 2） 检查情绪失调与a）病毒学失败和B）不完全ART之间的关联 坚持，评估适度和调解的家庭和社会因素;和3）使用二元深入 与AYALHIV和照顾者的访谈，以探索目标2中确定的情感 管理和艾滋病毒自我管理，以及家庭关系干预的经验，比较 有和没有情绪调节困难的AYALHIV。 方法：拟议研究的目标1和2将使用基线时收集的二次问卷数据 目标2还使用了病毒学状态（抽血）和ART依从性（尿 护理点测试）。在目标1中，将使用分层验证性因素分析来验证DERS-SF。 目标2将使用结构方程模型（SEM）来评估DERS-SF、病毒学 地位，以及家庭和社会因素的适度和调解;其次，类似的SEM可用于 评估与ART依从性的关系。目标3涉及AYALHIV/的主要定性数据收集 照顾者的二元关系，并将使用归纳法来获得目标2关系的细微差别的理解 和AYALHIV的干预经验，比较有和没有情绪调节困难的青少年。 奖学金信息：该研究是Kathleen里奇韦女士的博士论文 约翰霍普金斯布隆伯格公共卫生学院的学生。里奇韦女士的研究和培训将 在青少年艾滋病毒研究、定性方法和先进统计分析专家的支持下， 包括一名申办者、两名共同申办者和两名科学顾问。教学课程作业的结合， 导师，独立学习和实践经验将进一步女士里奇韦的职业目标，成为一个 在青少年健康和艾滋病方面的领先独立研究员。该提案直接回应了NIH 计划公告（PA-18-651）和特别关注通知（NOT-MH-20-035）， 为青少年和年轻人量身定制的艾滋病毒预防和护理研究。

PROJECT SUMMARY/ABSTRACT Background: Nearly two-thirds of adolescents and young adults living with HIV (AYALHIV) in Zambia have virologic failure. To date, limited research has assessed the role of developmental factors in achieving positive HIV self-management behaviors and favorable health outcomes among AYALHIV. A comprehensive understanding of these factors is essential to respond to the HIV epidemic among this high-priority population. Study Goal and Aims: Leveraging a parent study that tests the AYALHIV-caregiver Family Connections intervention in Zambia, the proposed research will validate and assess a measure of adolescent development – emotion regulation – in relation to virologic failure, ART adherence, and family and social factors. Specific aims are: 1) Validate the Difficulties in Emotion Regulation Scale (DERS-SF) among AYALHIV in Zambia; 2) Examine associations between emotion dysregulation and a) virologic failure and b) incomplete ART adherence, assessing moderation and mediation by family and social factors; and 3) Use dyadic in-depth interviews with AYALHIV and caregivers to explore relationships identified in Aim 2 between emotion regulation and HIV self-management, and experiences with the Family Connections intervention, comparing AYALHIV with and without emotion regulation difficulties. Approach: Aims 1 and 2 of the proposed research will use secondary questionnaire data collected at baseline by the parent study; Aim 2 also uses measures of virologic status (blood draw) and ART adherence (urine point of care test). In Aim 1, a hierarchical confirmatory factor analysis will be used to validate the DERS-SF. Aim 2 will use structural equation modeling (SEM) to assess relationships between the DERS-SF, virologic status, and moderation and mediation by family and social factors; secondarily, a similar SEM be used to assess relationships with ART adherence. Aim 3 involves primary qualitative data collection with AYALHIV/ caregiver dyads, and will use an inductive approach to gain a nuanced understanding of Aim 2 relationships and AYALHIV's intervention experiences, comparing youth with and without emotion regulation difficulties. Fellowship Information: The proposed research is the doctoral dissertation of Ms. Kathleen Ridgeway, a PhD student at the Johns Hopkins Bloomberg School of Public Health. Ms. Ridgeway's research and training will be supported by experts in adolescent HIV research, qualitative methods, and advanced statistical analysis and includes one Sponsor, two co-Sponsors, and two Scientific Advisors. A combination of didactic coursework, mentorship, independent study, and practical experience will further Ms. Ridgeway's career goal to become a leading independent researcher in adolescent health and HIV. This proposal directly responds to the NIH Program Announcement (PA-18-651) and Notice of Special Interest (NOT-MH-20-035) for developmentally tailored HIV prevention and care research for adolescents and young adults.