Hussen Sophia A, Andes Karen, Gilliard Danielle, Chakraborty Rana, Del Rio Carlos, Malebranche David J
Sophia A. Hussen, Karen Andes, and Carlos del Rio are with the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA. Sophia A. Hussen and Carlos del Rio are also with the Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine. Danielle Gilliard is with the Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University. Rana Chakraborty is with the Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine. David J. Malebranche is with the Division of Student Health Services, University of Pennsylvania, Philadelphia.
Am J Public Health. 2015 Apr;105(4):725-31. doi: 10.2105/AJPH.2014.301905. Epub 2014 Jun 12.
We conducted a qualitative study of HIV-positive young Black men who have sex with men (YBMSM) to explore their experiences of living with HIV and adhering to antiretroviral medications (ARVs) within the developmental context of their transition to adulthood.
We conducted life history interviews with 20 HIV-positive YBMSM in Atlanta, Georgia, engaged in outpatient HIV care. We addressed these questions: (1) How do YBMSM living with HIV experience the transition to adulthood? and (2) What are the important sociocontextual influences on ARV adherence for YBMSM?
Successful transition to adulthood and optimal ARV adherence were inextricably linked. HIV's detrimental impact on development was moderated by the degree of physical illness at diagnosis. Many participants described resilient trajectories while coping with HIV. Adherence problems occurred primarily among participants who were not meeting their developmental goals.
Our findings support the need for early diagnosis and linkage to care, as well as the need to develop holistic, resilience-based interventions focusing on transition to adulthood. These findings have implications for individual clinical outcomes as well as ARV-based prevention efforts among YBMSM.
我们对感染艾滋病毒的男男性行为黑人青年（YBMSM）进行了一项定性研究，以探讨他们在向成年过渡的发展背景下感染艾滋病毒并坚持服用抗逆转录病毒药物（ARV）的经历。
我们对佐治亚州亚特兰大市20名接受门诊艾滋病毒护理的感染艾滋病毒的YBMSM进行了生活史访谈。我们探讨了以下问题：（1）感染艾滋病毒的YBMSM如何体验向成年的过渡？（2）哪些重要的社会背景因素影响YBMSM坚持服用抗逆转录病毒药物？
成功过渡到成年与最佳的抗逆转录病毒药物依从性紧密相连。艾滋病毒对发育的有害影响因诊断时的身体疾病程度而有所减轻。许多参与者在应对艾滋病毒时描述了具有复原力的轨迹。依从性问题主要发生在未实现其发展目标的参与者中。
我们的研究结果支持早期诊断和与护理建立联系的必要性，以及制定注重向成年过渡的全面、基于复原力的干预措施的必要性。这些发现对个体临床结果以及YBMSM中基于抗逆转录病毒药物的预防工作具有启示意义。
