Marseille 2007
Marseille 2007
Abstract book
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Abstract #620  -  Coping Styles of Youth Infected with HIV: Disease Specific Stressors and Responses
Session:
  49.5: Late Breakers (Parallel) on Wednesday @ 08.30-10.30 in HC Chaired by Bruno Spire, Kate Hankins
Authors:
  Presenting Author:   Dr Lisa Orban - New York University School of Medicine, United States
 
  Additional Authors:  Dr Renee Stein, Dr Linda Koenig, Dr Latoya Conner, Dr Jennifer Lewis, Ms Erika Rexhouse, Dr Ricardo LaGrange,  
Aim:
The importance of understanding disease-related stressors and coping strategies among individuals with chronic illness has been well documented. Little is known, however, about coping styles of youth living with HIV or their relationship to the emotional functioning of these youth. This study aimed to examine coping strategies and styles in response to HIV-related stressors, and examine the relationship of coping styles with emotional functioning.
 
Method / Issue:
Data were from Adolescent Impact, a multi-site study of 166 adolescents with HIV (ages 13-21) in New York, Baltimore and Washington, DC. The majority (77%) of youth were African American; 52% were female, and 58% were infected by perinatal transmission. Youth were asked to identify a recent HIV-related stressor and complete the Kidcope (Spirito,1988), which measures use, frequency, and perceived effectiveness of 11 coping strategies in response to the stressor. Emotional and behavioral functioning were measured by the Achenbach System of Empirically Based Assessment (Achenbach & Rescorla, 2001; 2003). Depression was assessed by the Beck Depression Inventory (Beck, et al., 1971).
 
Results / Comments:
Medication-related stressors (e.g., side-effects and adherence; 30%) were the most commonly reported stressors among youth, with the majority of these stressors related to adherence issues (80%). When examining the structure of coping responses using factor analysis, a two-factor model (passive and active coping styles) emerged. Youth who reported medication-related stressors (n = 49) were less likely to use an active coping style than youth who did not report these stressors (t [163] = -3.04, p < .01). The most frequently used strategies among youth who reported adherence-related stressors were resignation and withdrawal, both of which were passive strategies. These strategies were used significantly more often than social support (p<.01) and problem-solving (p<.01), which were among the least frequently used, even though they were rated by participants as the most helpful. Youth with emotional problems in the clinical range endorsed a smaller number of different coping strategies than better adjusted youth (p<.01). Passive coping style was significantly associated with greater depression (r =.59, p < .01).
 
Discussion:
Youth identifying adherence-related stressors reported using resignation and withdrawal coping strategies most frequently. They were less likely to use social support strategies (e.g., talking to someone), possibly due to fear of stigma or unwanted disclosure. Problem-solving, a main component of adherence counseling, was also among the least frequently used strategies. This limitation may be due to deficits in knowledge or skills of how to directly address problems related to medication adherence. Given the need for long-term adherence to antiretroviral regimens, passive strategies such as resignation and withdrawal may eventually compromise the health of these youth. Passive coping was also significantly related to depression. Participants using passive coping may be responding to feelings of lack of control and frustration, which may lead to increased distress. Furthermore, youth with poorer emotional adjustment endorsed fewer coping strategies than better adjusted youth. Youth with HIV may benefit from theory-driven, tailored interventions to foster more adaptive coping with HIV-specific stressors, particularly those related to long-term adherence to antiretroviral medications.
 
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