The goals of the proposed five year study are to 1) determine the prevalence of Psychiatric Disorders and Behavioral Health Outcomes, including emotional and behavioral functioning, HIV risk behaviors, and adherence to medication in perinatally HIV-infected adolescents; 2) examine the association between HIV infection and Psychiatric Disorders and Behavioral Health Outcomes by comparing perinatally HIV-infected youth to uninfected youth exposed to HIV in utero (seroreverters); and 3) identify risk and protective factors related to Behavioral Health Outcomes in both groups prospectively over 18 months. To achieve the study goals, we will conduct a five year, longitudinal study of 200 perinatally HIV-infected children and 150 seroreverters, ages 9 - 16 years, residing in NYC, one of the epicenters of the HIV epidemic among women and children in the US. The proposed sample of 700 participants will consist of the child (n = 350) and his/her primary caregiver (n = 350). Two sources of data will be used: 1) caregiver and child interviews and 2) medical chart abstraction (lymphocyte subsets, HIV RNA viral load, CDC diagnosis, antiretroviral treatment, medical service utilization). Each participant will be individually interviewed at baseline and 18-month follow-up. The interview, guided by Social Action Theory, will assess Psychiatric Disorders, Behavioral Health Outcomes, and a range of determinants of Behavioral Health Outcomes. These determinants consist of the individual's self-regulation processes and the larger social, family, individual, and environmental context. In the proposed study, we emphasize the importance of the child's HIV status and psychiatric functioning as well as family factors (communication, supervision, and involvement) in influencing Behavioral Health Outcomes. Participants will be recruited from four major medical centers in NYC, each of which provides comprehensive medical and mental health care to HIV-infected children and seroreverters. Reflecting the pediatric HIV epidemic, the patients in these clinics are primarily African American and Latino, living in poverty in inner-city communities, with high HIV seroprevalence and rates of drug use. The proposed study will inform us about the specific stressors and correlates of mental health problems, as well as HIV risk behavior in this population. Thus, it will be a critical step in the development of effective interventions for a population that is fast emerging as a new risk group both in the US and in developing countries with 'limited access to treatment and other resources.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH069133-05
Application #
7324799
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Forsyth, Andrew D
Project Start
2003-12-11
Project End
2008-11-30
Budget Start
2007-12-01
Budget End
2008-11-30
Support Year
5
Fiscal Year
2008
Total Cost
$540,250
Indirect Cost
Name
New York State Psychiatric Institute
Department
Type
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
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Elkington, Katherine S; Peters, Zachary; Choi, C Jean et al. (2018) Predicting Arrest in a Sample of Youth Perinatally Exposed to HIV: The Intersection of HIV and Key Contextual Factors. AIDS Behav 22:3234-3243
Benson, Stephanie; Elkington, Katherine S; Leu, Cheng-Shiun et al. (2018) Association Between Psychiatric Disorders, Substance Use, and Sexual Risk Behaviors in Perinatally HIV-Exposed Youth. J Assoc Nurses AIDS Care 29:538-549
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Marhefka, Stephanie L; Green, Shana M; Sharma, Vinita et al. (2017) ""They said ""be careful'"": sexual health communication sources and messages for adolescent girls living with perintally-acquired HIV infection. AIDS Care 29:1265-1269
Elkington, Katherine S; Cruz, Jennifer E; Warne, Patricia et al. (2016) Marijuana Use and Psychiatric Disorders in Perinatally HIV-Exposed Youth: Does HIV Matter? J Pediatr Psychol 41:277-86
Mutumba, Massy; Bauermeister, Jose A; Elkington, Katherine S et al. (2016) A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths. J Adolesc Health 58:460-466
Evans, Shenell D; Mellins, Claude Ann; Leu, Cheng-Shiun et al. (2015) HIV treatment adherence measurement and reporting concordance in youth with perinatally acquired HIV infection and their caregivers. AIDS Patient Care STDS 29:43-51

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