Typology of Adherence in Adolescents: Phase II
- Conditions
- HIV Infection
- Registration Number
- NCT00106678
- Lead Sponsor
- University of North Carolina, Chapel Hill
- Brief Summary
A number of factors influence HIV-positive adolescents' acceptance of and willingness to continue taking anti-HIV medicines. These factors include mental health and substance abuse issues, barriers such as lack of medical insurance, and cognitive-behavioral barriers (such as a person's impression of the impact of the medicines on his/her health and a person's sense of his/her ability to continue taking the medications prescribed). The purpose of this study is to use a survey to determine how common specific barriers are that prevent HIV positive adolescents from taking their anti-HIV medicines and if those barriers cluster together. The information collected will be used to develop and validate a schema for classifying HIV medication adherence by barriers to adherence or clusters of barriers to adherence. This classification schema could then be used in the development of interventions that better meet the needs of HIV-infected youth.
- Detailed Description
As more HIV-infected adolescents are identified and linked into care, the dyad of medication and medication adherence continues to be an issue for both the provider and the patients. Thus, developing a strategy to assess adherence and barriers to adherence in this population is integral so that interventions can be targeted towards adolescents' specific needs. Our operating premise is that the issue of drug adherence is multi-factorial and that interventions that combine a variety of modalities may be preferred. However, before such interventions can be developed, we must first develop a tool that can be used to assess medication adherence and to identify barriers to medication adherence in this population.
This is a cross-sectional survey designed to assess the most prevalent combination of barriers to HIV medication adherence in adolescents. Specific barriers focused on in this study include mental health disorders, substance abuse, and cognitive-behavioral and structural barriers. In this Phase II study, the Adherence Staging Algorithm and the Participant Assessment Tool, pilot tested and modified based on findings from Phase I of the study, will be used to determine the prevalence of the specific barriers to adherence among HIV-infected youth requiring antiretroviral medication and the most common clusters of specific barriers. A cognitive-behavioral barriers schema for classifying HIV medication adherence in adolescents will be developed and validated.
The study consists of a one-time visit with a face-to-face interview to complete two questionnaires: the Adherence Staging Algorithm to classify the subject's adherence to his/her prescribed medications, and the Participant Assessment Tool to assess the prevalence of barriers to adherence that the subjects may have experienced. The interview takes no more than 30 minutes. In addition, the patient's medical record will be reviewed for HIV-related clinical data such as viral load, CD4, history of medications prescribed, and barriers the patient may have experienced such as mental health or substance abuse problems.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1200
- Between the ages of 12 years and 24 years
- Eligible for ART (antiretroviral therapy) based on US Public Health Service guidelines
- Have been offered and/or prescribed HAART (highly active antiretroviral therapy)
- Ability to give informed consent or assent with parental permission, where required
- Infected with HIV but do not require ART
- Started HAART but stopped due to medical reasons, (e.g., change in medication guidelines, toxicity, resistance, etc.)
- Females prescribed/receiving HAART for the purpose of preventing mother-to-child transmission
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (17)
Children's National Medical Center
🇺🇸Washington, District of Columbia, United States
University of Miami
🇺🇸Miami, Florida, United States
University of South Florida
🇺🇸Tampa, Florida, United States
Children's Diagnostic and Treatment Center
🇺🇸Fort Lauderdale, Florida, United States
University of Maryland Medical School
🇺🇸Baltimore, Maryland, United States
Children's Hospital of Los Angeles
🇺🇸Los Angeles, California, United States
University of California at San Francisco
🇺🇸San Francisco, California, United States
University of California at San Diego
🇺🇸San Diego, California, United States
Stroger Hospital of Cook County
🇺🇸Chicago, Illinois, United States
Mount Sinai Hospital
🇺🇸New York City, New York, United States
Weill Medical College of Cornell University-New York Presbyterian Hospital
🇺🇸New York City, New York, United States
Children's Hospital of Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
Tulane University
🇺🇸New Orleans, Louisiana, United States
University Pediatric Hospital
🇵🇷San Juan, Puerto Rico
Johns Hopkins Hospital
🇺🇸Baltimore, Maryland, United States
Childrens Hospital Boston
🇺🇸Boston, Massachusetts, United States
Montefiore Medical Center
🇺🇸Bronx, New York, United States