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Journal of Pediatric Psychology Advance Access published online on September 15, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp080
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Predictors of Medication Adherence in High Risk Youth of Color Living with HIV

Karen E MacDonell, PhD1, Sylvie Naar-King, PhD1, Debra A Murphy, PhD2, Jeffrey T Parsons, PhD3 and Gary W Harper, PhD MPH4

1Wayne State University, 2University of California, 3Hunter College and the Graduate Center of the City University of New York and 4DePaul University

All correspondence concerning this article should be addressed to Karen E. MacDonell, Wayne State University, Pediatric Prevention Research Center, Hutzel Building Suite w534, 4707 St. Antoine, Detroit, MI 48201, USA. E-mail: kkolmodin{at}med.wayne.edu


  Abstract

Objective To test predictors of medication adherence in high-risk racial or ethnic minority youth living with HIV (YLH) using a conceptual model of social cognitive predictors including a continuous measure of motivational readiness. Methods Youth were participants in a multi-site clinical trial examining the efficacy of a motivational intervention. Racial-minority YLH (primarily African American) who were prescribed antiretroviral medication were included (N = 104). Data were collected using computer-assisted personal interviewing method via an Internet-based application and questionnaires. Results Using path analysis with bootstrapping, most youth reported suboptimal adherence, which predicted higher viral load. Higher motivational readiness predicted optimal adherence, and higher social support predicted readiness. Decisional balance was indirectly related to adherence. Conclusions The model provided a plausible framework for understanding adherence in this population. Culturally competent interventions focused on readiness and social support may be helpful for improving adherence in YLH.

Key words: Adherence; adolescents; HIV; minority populations; young adults..

Received September 29, 2008; revision received August 13, 2009; accepted August 16, 2009


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[Abstract] [Full Text] [PDF]


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