Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women

Dodds, Sally; Blakley, T; Lizzotte, J.M; Friedman, Lawrence B; Shaw, Kimberly; Martinez, Jaime; Siciliano, Carl; Walker, Lynn E; Sotheran, Jo L; Sell, Randall L; Botwinick, Geri; Johnson, Robert L; Bell, Douglas

doi:10.1016/S1054-139X(03)00157-5

« Previous Next »Journal of Adolescent Health
Volume 33, Issue 2, Supplement , Pages 39-45, August 2003

Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women

Sally Dodds, Ph.D., L.C.S.W.
- Department of Psychiatry and Behavioral Sciences, Women’s Mental Health Programs, University of Miami, Miami, Florida, USA (S.D., T.B., J.M.L.)
T Blakley, M.S.W.
- Department of Psychiatry and Behavioral Sciences, Women’s Mental Health Programs, University of Miami, Miami, Florida, USA (S.D., T.B., J.M.L.)
J.M Lizzotte
- Department of Psychiatry and Behavioral Sciences, Women’s Mental Health Programs, University of Miami, Miami, Florida, USA (S.D., T.B., J.M.L.)
Lawrence B Friedman, M.D.
- Department of Pediatrics, Division of Adolescent Medicine, University of Miami School of Medicine, Miami, Florida, USA (L.B.F.)
Kimberly Shaw, Ph.D.
- Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA (K.S.)
Jaime Martinez, M.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)
Carl Siciliano
- SafeSpace, New York, New York, USA (C.S., L.E.W.)
Lynn E Walker
- SafeSpace, New York, New York, USA (C.S., L.E.W.)
Jo L Sotheran, Ph.D.
- Mailman School of Public Health, Columbia University, New York, New York, USA (J.L.S., R.L.S.)
Randall L Sell, Sc.D.
- Mailman School of Public Health, Columbia University, New York, New York, USA (J.L.S., R.L.S.)
Geri Botwinick, M.P.A.
- Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA (K.S.)
Robert L Johnson, M.D.
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, UMDNJ–New Jersey Medical School, Newark, New Jersey, USA (R.L.J., G.B.)
Douglas Bell, Ph.D.
- Division of Adolescent Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA (J.M., D.B.)
- Address correspondence to: Robert L. Johnson, M.D., F.A.A.P., Professor and Interim Chair of Pediatrics, Department of Pediatrics, UMDNJ—New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07101, USA.

Accepted 29 April 2003.

Abstract

Purpose

To demonstrate that whereas all HIV-infected youth evidence complex factors that challenge retention in care and adherence to treatment, HIV-infected females have additional issues that are gender-specific.

Methods

Preliminary data from a subset of 21 adolescent/young women under age 25 from the Whole Life mental health-perinatal HIV care project were analyzed to illustrate the needs of these patients.

Results

Of the 21 young women assessed, all but one was of minority background, and a sizeable majority had limited education (<high school diploma) and were quite poor (incomes <$500/mo.). Nearly 67% first learned of their HIV status between ages 16 and 19 years. More than three-fourths were pregnant and, of these, more than one-third entered prenatal care in the last trimester. More than half had responsibility for one to two other children. Two-thirds reported having unprotected sex in the prior 6 months. Nearly 43% had CD4 counts of 500 or below. About one-third screened positive for a mental health problem, and the majority reported a striking frequency of exposure to abusive events and traumatic losses across their short lifetimes.

Conclusions

Adolescent girls and young women have unique needs for developmentally appropriate medical and psychosocial approaches to promote retention and adherence.

Keywords: HIV adolescent females, HIV adolescents, HIV retention, HIV youth