April 23, 2010
The study's goal was to identify factors associated with appointment-keeping among HIV-positive adolescents and young adults.
To determine their adherence to scheduled clinic visits with their HIV care provider, HIV-positive adolescent and young adult females in five US cities were followed for 18 months. At baseline and follow-up visits, an audio computer-assisted self-interview questionnaire was used to measure psychosocial and behavioral factors that have been shown in other populations to influence appointment adherence. These factors included mood disorder, depressive symptoms, social network support, satisfaction with health care, acceptance of disease, HIV stigma, alcohol use, and marijuana use. To understand the influence of health status on appointment-keeping, CD4 cell count and prescription of antiretroviral therapy medication were also monitored.
A total of 178 youths were included; their mean age was 20.6. The results showed 42 percent had clinically significant depressive symptoms; 10 percent had a diagnosable mood disorder; 37 percent reported marijuana use in the previous 90 days; and 47 percent reported alcohol use. After controlling for age and health status, the only variable associated with appointment-keeping behavior was marijuana use.
"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," the authors concluded.