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Secondary prevention for HIV-positive adolescents: psychosocial functioning, health promoting factors, and disease control
Dissertation   Open access

Secondary prevention for HIV-positive adolescents: psychosocial functioning, health promoting factors, and disease control

Despina Colette Nicolaou
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2007
DOI:
https://doi.org/10.17918/etd-1786
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Abstract

HIV-positive persons Adolescent Psychology Clinical Psychology
Objective: Prevalence rates of human immunodeficiency virus (HIV) continue to rise among adolescents within the United States and internationally. However, significant medical advancements have increased the life expectancy of children and adolescents with HIV in the US. Therefore, recent attention has been placed on the psychosocial functioning of this population, including the socio-economic environmental context in which they function, in order to understand increased risks for maladjustment and behavioral outcomes. Relatively little empirical research exists examining interventions aimed at reducing transmission and improving the emotional well-being of youth with HIV. This study investigated the Academy of Teen Peers (ATP) program designed to educate adolescents with HIV and support psychosocial well-being, healthpromoting behaviors, and disease control. Methods: Thirty-eight participants completed baseline assessments (M age= 16.37, SD= 1.87, range= 13-20), of which 57.9% were perinatally infected with HIV. Sixteen youth completed both baseline and Time 2 measures. Correlation analyses were run to assess the relationship between psychological variables, including health locus of control (HLOC), self-esteem, selfefficacy, and high risk sexual behaviors, as well as disease control from baseline data. Subsequent ANOVA/ANCOVAs were conducted to detect changes associated with participation in ATP. Results: Findings did not reveal a significant relationship between psychological variables, health-promoting factors, and disease outcome. However, several significant adaptive improvements in terms of HLOC, self-esteem, sexual health attitudes, and HIV knowledge were detected from baseline to Time 2. Additional improvements in adherence and viral loads were observed. However, high risk sexual behaviors were found to increase over time. Discussion: This study suggests that adult behavioral health models may not reflect the context in which youth with HIV function. Rather, additional models must be developed in order to address the specific cultural, socioeconomic, and illness-related experiences of this population, within a developmentally appropriate framework. In addition, this study supports the use of ATP as a method for improving several psychosocial and disease control outcomes, including adherence to antiretroviral medications. However, given several methodological limitations, findings are preliminary. Further research is needed among larger samples in order to explore barriers to reductions in health-promoting behaviors and high risk sexual activity.

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