Career Development Plan: The applicant is requesting 5 years of funding through the Mentored Patient- Oriented Research Career Development Award (K23-PA-05-143) to develop her into an independent investigator in HIV/AIDS health disparities research, with an emphasis on investigating the sociocultural aspects of antiretroviral adherence and biologic outcomes with HIV+ Hispanics. Career Development Methods: A coordinated, mentored curriculum of didactic and research training and study development is proposed. Dr. Rivera Mindt will receive guidance from her mentors;will complete formal coursework and training in sociocultural and adherence research, HIV/AIDS biologic outcomes, advanced research methodology, biostatistics and epidemiology, and the ethical conduct of research;and participate in related local seminars and national scientific meetings. Scientific Background: The Hispanic community is the largest and fastest growing racial/ethnic minority group in the U.S., and is disproportionately affected by the HIV/AIDS epidemic and myriad social risk factors. However, little is known regarding how sociocultural factors impact antiretroviral adherence in this group. The proposed study will examine the sociocultural determinants of antiretroviral adherence in a sample of HIV+ Hispanic and non-Hispanic white adults using electronic medication monitoring technology. Specific Research Aims: 1) To determine whether sociocultural factors are individually associated with antiretroviral adherence and biological outcomes among HIV+ Hispanics;2) To evaluate the impact of culture on antiretroviral adherence and biological outcomes, after accounting for the impact of social risk factors;and 3) To examine whether sociocultural """"""""risk factors"""""""" mediate the effect of ethnicity on antiretroviral adherence, and to examine explicitly the effects of neuropsychological (NP) functioning in this association. Research Methods: Dr. Rivera Mindt will lead a study of antiretroviral adherence utilizing advanced, electronic medication monitoring technology for 100 HIV+ Hispanic and 50 non-Hispanic white adults. Significance: This study will enhance our understanding of antiretroviral adherence among HIV+ Hispanics &lead to innovative, culturally tailored interventions to increase antiretroviral adherence in this group. This project will also lead to a larger-scale, longitudinal study of sociocultural factors in antiretroviral adherence among this historically under-served group.
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