Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
J Adolesc Health. 2010 Mar;46(3):278-83. doi: 10.1016/j.jadohealth.2009.06.013. Epub 2009 Jul 23.
Identify factors associated with appointment-keeping among HIV-infected adolescents and young adults.
HIV-infected adolescent and young adult females in five U.S. cities were followed for a period of 18 months to examine adherence to scheduled clinic visits with their HIV care provider. Psychosocial and behavioral factors that have been shown in other populations to influence appointment adherence were measured at baseline and follow-up visits using an audio computer-assisted self-interview questionnaire. These factors included mood disorder, depressive symptoms, social network support, healthcare satisfaction, disease acceptance, HIV stigma, alcohol use, and marijuana use. CD4 count and prescription of antiretroviral therapy medication were also monitored to understand the influence of health status on appointment- keeping.
Participants included 178 youth with a mean age of 20.6 years. Forty-two percent had clinically significant depressive symptoms, 10% had a diagnosable mood disorder, 37% reported marijuana use in the last 90 days, and 47% reported alcohol use. Overall, participants attended 67.3% of their scheduled visits. Controlling for age and health status, marijuana use was the only variable that was associated with appointment-keeping behavior.
Considering the importance of appointment-keeping for maintaining personal health and preventing further transmission, screening HIV-infected adolescents for marijuana use could help alert providers of this specific barrier to visit compliance.
确定与 HIV 感染的青少年和年轻人守约相关的因素。
在美国五个城市对 HIV 感染的青少年和年轻女性进行了为期 18 个月的随访，以检查其与 HIV 护理提供者预约门诊的依从性。在基线和随访时使用音频计算机辅助自我访谈问卷测量了其他人群中已显示影响预约依从性的心理社会和行为因素。这些因素包括情绪障碍、抑郁症状、社会网络支持、医疗保健满意度、疾病接受度、HIV 耻辱感、酒精使用和大麻使用。还监测了 CD4 计数和抗逆转录病毒治疗药物的处方，以了解健康状况对预约遵守的影响。
参与者包括 178 名平均年龄为 20.6 岁的年轻人。42%的人有临床显著的抑郁症状，10%的人有诊断明确的情绪障碍，37%的人在过去 90 天内使用过大麻，47%的人报告有饮酒行为。总体而言，参与者参加了 67.3%的预约就诊。控制年龄和健康状况后，大麻使用是唯一与预约行为相关的变量。
考虑到守约对维持个人健康和预防进一步传播的重要性，对感染 HIV 的青少年进行大麻使用筛查可能有助于提醒提供者注意这一特定的就诊依从性障碍。
