Engaging Care for HIV-infected Adolescent Females.
Condition: HIV Infection
MeSH terms: HIV Infections
Study type: Observational

Summary: 
      The proposed multi-site, longitudinal study will examine the correlation of substance use,
      mental health disorders, and social networks to engagement in care for HIV-infected
      adolescent females, aged 13 years, 0 months - 23 years, 11 months, and suggest ways to
      promote adherence and retention in treatment, care, and prevention programs. Qualitative and
      quantitative data collection methods will be used with index participants and network
      members.
    

Detailed description: 
      The primary outcome examined in the proposed study is engagement in care, operationalized as
      the number of clinical visits attended. Clinic visits will be monitored on a weekly basis.
      Secondary outcomes of interest include medication adherence, sexual risk behaviors, and
      substance use. For the quantitative study, formal psychological testing will be conducted
      with index adolescent females, and biological specimens will be collected to validate
      self-reported drug use. CD-4 counts and viral load will be monitored every three months via
      chart review.

      Index adolescents will be interviewed every six months (with phone interviews focused on
      service utilization at each six month interval midpoint) for eighteen months while network
      members will be interviewed at baseline and one year.

      Qualitative interviews in the Ethnographic Study will be conducted with a small sub-sample of
      index and identified network participants from each site at least monthly for a period of at
      least 18 months. Qualitative interviews will be ethnographic in nature and will rely on
      participants' life stories and narratives of social experience to supply their content and to
      guide their progression.

      Qualitative Interviews in the Gender Substudy will be conducted with a subsample of index
      participants. These qualitative interviews will focus on issues of gender related
      vulnerabilities and will be used to develop a survey to be administered to all index
      participants from sites participating in this substudy.
    

Intervention name(s): Quantitative Interview; Ethnographic Interview; Gender Interview
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Index participants will be interviewed every six months (with phone interviews focused on service utilization at each six month interval midpoint) for 18 months while network members will be interviewed at baseline and one year. Interviews will consist of in-depth face-to-face and audio computer-assisted interviews (ACASIs) and a structured diagnostic interview to assess engagement in care (number of clinical visits attended), substance use, attitudes about substance use, friend's substance use, sexual risk behaviors, PTSD (for index participants only), support of index participants care use (network participants only), attitudes about healthcare (network participants only), index participant's adherence (network participants only), own functioning (network participants only), and family functioning (network participants only). At Baseline only, a urine sample will be collected from index participants for drug testing to assess the agreement between urine and ACASI.; Qualitative interviews will be conducted with a small sub-sample of index and identified network participants from each site at least monthly for a period of 18 months. Interviews will be ethnographic in nature and will rely on participants' life stories and narratives of social experience to supply their content and guide their progression.; Qualitative interviews will be conducted with a sub-sample of index participants. These interviews will focus on issues of gender related vulnerabilities and will be used to develop a survey.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        HIV-infected adolescent females, aged 13 years, 0 months - 23 years, 11 months will be
        followed to examine the correlation of substance use, mental health disorders, and social
        networks to engagement in care and suggested ways to promote adherence and retention in
        treatment, care, and prevention.
      
Keywords: HIV; adolescent females; adherence; clinical care; risk behaviors