266589 “I'm just like everyone else, I just happen to be HIV positive”: The factors that contribute to medication adherence and risk behaviors among young HIV positive African American Women

Tuesday, October 30, 2012 : 5:30 PM - 5:50 PM

Sarah Finocchario-Kessler, PhD, MPH , Department of Family Medicine, The University of Kansas Medical Center, Kansas City, KS
Natabhona Mabachi, PhD, MPH , Family Medicine, Kansas University Medical Center, Kansas City, KS
Jacinda Dariotis, PhD, MAS, MA, MS , Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Kathy Goggin, PhD , Department of Psychology, University of Missouri-Kansas City, Kansas City, MO
Jean Anderson, MD , Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
K. Allen Greiner, MD, MPH , Center for American Indian Community Health, and Department of Family Medicine, Kansas University Medical Center, Kansas City, KS
Michael Sweat, PhD , Psychiatry and Behavioral Sciences, Medical University of South Caroline, Charleston, SC
Background: High levels of non-adherence to antiretroviral (ART) therapy persist despite ART's ability to extend a young person's life expectancy 40 years beyond medication initiation. This non-adherence is compounded by the fact that drug use and risky sexual behaviors typically occur during youth. Furthermore, compared to their HIV negative counterparts, behaviorally and perinatally infected adolescents and young adults have higher rates of cognitive impairments and mental health issues.

Purpose: This qualitative study illuminates unique factors that influence medication adherence and risky behavior among young, HIV + African American women.

Methods: Twenty semi-structured in-depth interviews were conducted with HIV+ young women (mean age =28.8, 95% African American, 50% on ART) receiving HIV care in an urban clinic. A thematic analysis of interviews was conducted independently by two study team members before reaching consensus on emergent themes.

Results: Participants experienced various tensions in their life causing them to oscillate along a continuum of medication adherence and risk taking behaviors. Factors influencing this oscillation were organized into the following themes: 1.Mental health issues (depression, anxiety, past trauma due to abuse), 2. Stigma (leading to selective/lack of disclosure, sexual/social isolation), 3. Coping mechanisms (positive reappraisal and cognitive avoidance) and 5. Future aspirations (desire to have a child, desire for independence).

Conclusion: Understanding the unique factors that cause young people to oscillate along the continuum of adherence and risk taking behavior allows us to implement strategies that can be used to move youth towards consistent medication adherence and safe behaviors.

Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
1.Describe the role of HIV in the lives of young HIV+ African American women 2.Explain the factors that influence oscillation along the continuum of medication adherence and risk taking behaviors among young African American women

Keywords: HIV/AIDS, Youth

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A

Qualified on the content I am responsible for because: the content of this abstract reflects the qualitative component of my PhD dissertation research conducted at the Johns Hopkins Hospital. I conducted the interviews and their analyses. I have a PhD in Public Health and am currently a Research Instructor at the Kansas University Medical Center, Department of Family Medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.