ECODEVELOPMENTALLY BASED STUDY OF EPIDEMIOLOGICAL AND SELF-PERCEIVED INDICES OF HIV RISK AMONG YOUNG AFRICAN AMERICANS- A COMPARATIVE ANALYSIS
Author(s)
Li Y1, Mgbere O2, Abughosh S1, Chen H1, Cuccaro P3, Essien EJ1
1University of Houston, Houston, TX, USA, 2Houston Department of Health and Human Services, Houston, TX, USA, 3University of Texas School of Public Health, Houston, TX, USA
OBJECTIVES: This study examined the association between epidemiological and self-perceived risks of contracting the human immunodeficiency virus (HIV) among young African Americans (AA) and the multi-level factors (micro-, meso-, exo-, and macro-systems) identified based on the ecodevelopmental theory. METHODS: A retrospective cross-sectional study was conducted using 1,619 AA youth ages 14.2-17.8 years in wave 1 of the National Longitudinal Study of Adolescent Health. Epidemiological and self-perceived indices of HIV risk were developed and their associations between and within the ecodevelopmental systems were evaluated using Chi-square and Cohen’s Kappa statistics. RESULTS: Findings revealed significant discordance (p<0.0001) in young AAs’ risk status based on the two assessment methods, with a Cohen’s Kappa coefficient of 0.1443 (95% CI: 0.1434-0.1452). Using the epidemiological index as the “gold standard", 55.72% of the study sample was able to accurately assess their risk levels through self-perception with significant variations noted cross the ecodevelopmental systems. Inaccurate risk estimates were generally associated with being male, low parents’ function (not having a mother, feeling less close to their father), and low academic performance. Additionally, high epidemiologic risk status was associated with age at sexual debut, weak family function (living alone, having a loose bond with their biological father), loose connection in schools and to their neighborhoods (having difficulty getting along with teachers, and having fewer social interactions), and having more sexually active friends (who contracted sexually transmitted diseases, and frequently using condoms). CONCLUSIONS: The disparity noted between self-perceived and epidemiological risks for contracting HIV in our study underscore the need for effective HIV educational programs targeting young AA and their parents. The implication of ecosystemic processes at different levels within the risk status - particularly family and school functioning, and parental social support indicate that ecodevelopmentally-based interventions may be valuable in preventing the risk of HIV transmission among AA adolescents.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
PIN49
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities
Disease
Infectious Disease (non-vaccine), Pediatrics