Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women.
OBJECTIVE
To demonstrate that whereas all HIV-infected youth evidence complex factors that challenge retention in care and adherence to treatment, HIV-infected females have additional issues that are gender-specific.


METHODS
Preliminary data from a subset of 21 adolescent/young women under age 25 from the Whole Life mental health-perinatal HIV care project were analyzed to illustrate the needs of these patients.


RESULTS
Of the 21 young women assessed, all but one was of minority background, and a sizeable majority had limited education (<high school diploma) and were quite poor (incomes <$500/mo.). Nearly 67% first learned of their HIV status between ages 16 and 19 years. More than three-fourths were pregnant and, of these, more than one-third entered prenatal care in the last trimester. More than half had responsibility for one to two other children. Two-thirds reported having unprotected sex in the prior 6 months. Nearly 43% had CD4 counts of 500 or below. About one-third screened positive for a mental health problem, and the majority reported a striking frequency of exposure to abusive events and traumatic losses across their short lifetimes.


CONCLUSIONS
Adolescent girls and young women have unique needs for developmentally appropriate medical and psychosocial approaches to promote retention and adherence.
Dodds
Sally
S
Department of Psychiatry and Behavioral Sciences, Women's Mental Health Programs, University of Miami, Miami, Florida, USA.
Blakley
T
T
Lizzotte
J M
JM
Friedman
Lawrence B
LB
Shaw
Kimberly
K
Martinez
Jaime
J
Siciliano
Carl
C
Walker
Lynn E
LE
Sotheran
Jo L
JL
Sell
Randall L
RL
Botwinick
Geri
G
Johnson
Robert L
RL
Bell
Douglas
D
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006302:Health Services Research; D006801:Humans; D020380:Needs Assessment; D010349:Patient Compliance; D010352:Patient Dropouts; D018743:Perinatal Care; D018456:Reproductive Medicine; D012944:Social Support; D014481:United States; D014932:Women's Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data
D019380:Anti-HIV Agents