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Profiles of Risk Among HIV-Infected Youth in Clinic Settings

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Abstract

Despite the rising number of new HIV infections among youth, few tailored interventions for youth living with HIV (YLH) have been developed and rigorously tested. Developing tailored interventions necessitates identifying different profiles of YLH and understanding how risk and protective factors cluster together. Obtaining this critical information requires accessing a sufficiently large sample of YLH from diverse geographic settings such as those available through the Adolescent Trials Network for HIV Interventions (ATN). We recruited a cross-sectional sample of 1,712 YLH from ATN clinics; participants completed a survey on psychosocial and health factors. Using latent class analysis on nine composite variables representing risk factors, we identified five classes distinguished by substance use, sexual behavior, and pregnancy history and differing on health outcomes. Findings suggest a need for tailored interventions addressing multiple risky behaviors of HIV-infected youth and research to clarify how intervention effectiveness may differ by risk profile.

Resumen

A pesar del creciente número de nuevas infecciones por el VIH entre los jóvenes, pocas intervenciones apropiadas para jóvenes que viven con VIH (JVIH) se han desarrollado y probado rigurosamente. Desarrollar este tipo de intervenciones requiere identificar diferentes grupos de JVIH y comprender las formas en que los factores asociados con comportamientos que elevan o disminuyen el riesgo de transmitir VIH se agrupan. Obtener estos datos críticos requiere tener acceso a una muestra suficientemente grande de JVIH de diversos entornos geográficos tales como son disponible a través de las clínicas asociadas con la red de investigación llamada ATN. Para este estudio, reclutamos una muestra de 1,712 JVIH de clínicas de ATN para completar una encuesta sobre factores psicosociales y de salud. Usando análisis de clases latente basado en nueve variables combinadas que representan los factores de riesgo, identificamos cinco clases o grupos. Las características de los miembros de las clases variaban por uso de drogas, frecuencia de sexo sin protección, un historial de embarazos, e índices de salud. Los resultados indican que existe la necesidad de desarrollar intervenciones que abarcan múltiples comportamientos de riesgo apropiados para de los JVIH e investigar como los efectos de estas intervenciones varían de acuerdo a las clases de riesgo.

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Acknowledgments

This work was supported by The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health [U01 HD 040533 and U01 HD 040474] through the National Institute of Child Health and Human Development (B. Kapogiannis, S. Lee), with supplemental funding from the National Institutes on Drug Abuse (K. Davenny, S. Kahana) and Mental Health (P. Brouwers, S. Allison). The study was scientifically reviewed by the ATN’s Behavioral Leadership Group. Network, scientific and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow) at The University of Alabama at Birmingham. Network operations and data management support was provided by the ATN Data and Operations Center at Westat, Inc. (J. Korelitz, B. Driver). We acknowledge the contribution of the investigators and staff at the following sites that participated in this study: the following ATN sites participated in this study: University of South Florida, Tampa (Emmanuel, Lujan-Zilbermann, Julian), Children’s Hospital of Los Angeles (Belzer, Flores, Tucker), Children’s National Medical Center (D’Angelo, Hagler, Trexler), Children’s Hospital of Philadelphia (Douglas, Tanney, DiBenedetto), John H. Stroger Jr. Hospital of Cook County and the Ruth M. Rothstein CORE Center (Martinez, Bojan, Jackson), University of Puerto Rico (Febo, Ayala-Flores, Fuentes-Gomez), Montefiore Medical Center (Futterman, Enriquez-Bruce, Campos), Mount Sinai Medical Center (Steever, Geiger), University of California-San Francisco (Moscicki, Auerswald, Irish), Tulane University Health Sciences Center (Abdalian, Kozina, Baker), University of Maryland (Peralta, Gorle), University of Miami School of Medicine (Friedman, Maturo, Major-Wilson), Children’s Diagnostic and Treatment Center (Puga, Leonard, Inman), St. Jude’s Children’s Research Hospital (Flynn, Dillard), Children’s Memorial Hospital (Garofalo, Brennan, Flanagan). The investigators are grateful to the members of the local youth Community Advisory Boards for their insight and counsel and are particularly indebted to the youth who participated in this study. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of NIDA or any of the sponsoring organizations, agencies, or the US government.

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Authors and Affiliations

  1. Department of Preventive Medicine, College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA

    M. Isabel Fernández

  2. Department of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA

    M. Isabel Fernández

  3. Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, CA, USA

    Heather C. Huszti

  4. Department of Sociomedical Sciences, Columbia University, New York City, NY, USA

    Patrick A. Wilson

  5. National Institute on Drug Abuse, National Institutes of Health, Bethesda, MA, USA

    Shoshana Kahana

  6. Department of Neurosciences, University of California, San Diego, CA, USA

    Sharon Nichols

  7. Westat Inc., Rockville, MD, USA

    René Gonin & Jiahong Xu

  8. Maternal and Pediatric Infectious Disease Branch, National Institute of Child Health and Human Development, Bethesda, MA, USA

    Bill G. Kapogiannis

  9. 2000 S. Dixie Hwy Suite 108, Miami, FL, 33133, USA

    M. Isabel Fernández

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  1. M. Isabel Fernández
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  2. Heather C. Huszti
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  4. Shoshana Kahana
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  8. Bill G. Kapogiannis
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Correspondence to M. Isabel Fernández.

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The ATN 086 Protocol Team for the Adolescent Medicine Trials Network for HIV/AIDS Interventions.

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Fernández, M.I., Huszti, H.C., Wilson, P.A. et al. Profiles of Risk Among HIV-Infected Youth in Clinic Settings. AIDS Behav 19, 918–930 (2015). https://doi.org/10.1007/s10461-014-0876-y

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