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Dissertation
Posttraumatic stress in adolescents with HIV and its relationship with treatment adherence: the role of health beliefs
Doctor of Philosophy (Ph.D.), Drexel University
Apr 2010
DOI:
https://doi.org/10.17918/etd-3221
Abstract
Objective: The introduction of HAART has led to increased life expectancy among youth with HIV, however, it poses challenges including complex drug regimens that require strict adherence by patients. Treatment adherence by youth with HIV is generally considered suboptimal, although adherence reports vary by the method of assessment used. Given the prevailing problem of treatment adherence in this population, research has focused on identifying factors contributing to nonadherence. Research on adults with HIV and children with other chronic illnesses suggests that posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), and health beliefs may be important factors relating to nonadherence. This study investigated the prevalence of PTSS in a sample of adolescents and young adults perinatally and behaviorally-infected with HIV. The relationship of PTSS with treatment adherence and the role of internal health locus of control (IHLC) were explored. Methods: Twenty-eight participants (M age = 17.14, SD = 3.05; range = 12-22) recruited from a pediatric immunology clinic completed measures of life events, posttraumatic stress symptoms, and health locus of control. Measures of treatment adherence used included: viral load count, CD4 count, and provider ratings of adherence. Results: Findings revealed relatively good adherence levels and low disease severity among the sample. Eighty-two percent of participantsreported experiencing a least one HIV-related traumatic event and 75% of participants reported experiencing at least one non-HIV related traumatic event. Posttraumatic stress symptom severity scores fell in the moderate range of severity for both HIV-related and general traumas. No differences were found in trauma scores based on mode of transmission or developmental level (adolescents vs. young adults). Provider ratings of adherence and viral load were correlated with PTSS. IHLC did not demonstrate a significant indirect effect on the relationship between treatment adherence and PTSS. Discussion: Difficulties in recruitment for this study point to the many stressors facing youth with HIV and the barriers to successful recruitment of ethnic minority participants in research. Findings highlight the need to address psychosocial problems among youth with HIV, in particular posttraumatic stress, in order to improve treatment adherence and health outcomes. Further research is needed to clarify the role of health beliefs as they relate to health-promoting behaviors in this population. Additionally, future research is needed to establish standardized, valid, reliable, and cost-effective measures of adherence. Barriers to recruitment and retention of ethnic minority participants must also be addressed. Findings are limited by small sample size, low power, and restriction of range in data.
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Details
- Title
- Posttraumatic stress in adolescents with HIV and its relationship with treatment adherence
- Creators
- Beverley Slome Weinberger - DU
- Contributors
- Jacqueline D. Kloss (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 3221; 991014632301704721