Health Protective Behaviors among Young People Living with HIV/AIDS

Ricardo D Lagrange

doi:10.4172/2155-6113.s1-013

Abstract

Young people living with HIV/AIDS (YPLH) in the post-HAART era have the potential to manage their HIV as a chronic illness rather than as an almost inevitable terminal disease. However, little is known about behaviors YPLH can engage in to promote or protect health beyond taking anti-retroviral (ARV) medicines. The current study fills an important gap in existing research by identifying correlates of Health Protective Behaviors (HPB) within an urban sample of YPLH. Participants (n=134) were recruited from two pediatric clinics serving adolescents living with HIV who met the following criteria: HIV-infected and aware of their status, 13-24 years old, residing in the Washington, DC metropolitan area, currently prescribed ARV or due to begin ARV within 3 months, and able to understand and sign a written consent form. Each participant was interviewed via Audio computer-assisted self-interview (ACASI) and reported the percentage of possible time they engaged in six HPB during the prior month using a 10-point scale (e.g., 5=50%). Results indicate that most patients engaged in the measured health protective behaviors more than half the time, although patients 18 and older engaged in all HPB less frequently than their younger counterparts. Patients with adherence > 90% were far more likely to engage in HPB than those with poorer adherence. The age differences in HPB highlight a need for broader scaffolding in the transition to independent living and adult health care. Given the relationship between adherence and HPB, the establishment and maintenance of healthy lifestyle practices early in adolescence can translate into positive long-term health outcomes.

Highlights

IntroductionDevelopment of the multi-drug combination therapy known as HAART (highly active antiretroviral treatment) profoundly changed how HIV was treated in the mid-1990s
Development of the multi-drug combination therapy known as HAART profoundly changed how HIV was treated in the mid-1990s
A similar association with viral load was found for taking ARV medications; those with lower viral loads were reported taking their medications more frequently. In this sample of urban, predominately African American young people living with HIV (YPLH), we found that most patients engaged in the measured health protective behaviors more than half the time

Summary

Introduction

Development of the multi-drug combination therapy known as HAART (highly active antiretroviral treatment) profoundly changed how HIV was treated in the mid-1990s. In a span of less than 10 years, the death rate from HIV/AIDS declined by 50–80% [1] with numerous studies crediting the adoption of antiretroviral (ARV) medication for the marked and sustained reductions in AIDS-related morbidity and mortality rates [2,3,4,5,6]. Much of the focus on secondary prevention for young people living with HIV (YPLH) has been directed at improving adherence rates to ARV treatment, given recent reports of the relationship between community viral load (i.e., average viral load within a population) and transmission rates [7]. With the increasing number of YPLH surviving into adulthood [12], non-adherence has serious public health implications; elevated viral loads increase the likelihood of transmission during unprotected sex [13], and non-adherent individuals may be more likely to transmit drug resistant strains of HIV [14]

Methods

Results

Discussion

Conclusion