Coping strategies of adolescents living with HIV: disease-specific stressors and responses

Abstract

This study examined disease-specific stressors and coping responses employed by youth with HIV. Data were analyzed from Adolescent Impact, a multi-site study of 166 adolescents infected with HIV in three major US cities. Participants identified HIV-related stressors during a face-to-face interview. Coping strategies were measured using the adolescent version of the Kidcope. Emotional and behavioral functioning were assessed with the Youth or Adult Self Report symptom checklists. Medication-related stressors were most common (30%) and reported more often by perinatally infected youth, whereas youth infected through risk behaviors reported more disclosure-related stressors. Passive emotional regulation was perceived as the most used and most helpful coping strategy overall. Youth reporting medication adherence-related stressors used resignation most frequently. A two-factor model (Passive and Active Coping) emerged. The Passive Coping factor included strategies that do not directly approach the problem, whereas Active Coping included strategies that involve an active approach. Youth with moderately advanced disease (CD4 200–500 cells/mm³) used a Passive Coping style more often than healthier youth (CD4 > 500 cells/mm³). Additionally, Passive Coping was associated with greater emotional and behavioral problems. Youth infected with HIV may benefit from interventions promoting adaptive coping responses to HIV-specific stressors, particularly medication adherence.

Keywords:

• coping
• HIV
• AIDS
• stressors
• adolescents

Acknowledgements

The authors would like to thank Lawrence D'Angelo, MD; William Barnes, PhD; Jean Fletcher, RN; Maureen Lyon, PhD; Kathryn Platky; Yolanda Peele, MEd; Anne Sill, MS; Connie Trexler, RN, from Children's National Medical Center; Washington, DC; Ligia Peralta, MD; Vicki Tepper, PhD; John Farley, MD; Hibest Assefa, MPH; Maria Metcalf, MPH; Rhonda Phill, MPH, from University of Maryland School of Medicine; Baltimore, MD; Sulachni Chandwani, MD; Susan Abramowitz, PhD; Joe Stavola, MD; Stephanie Marhefka, PhD; David Moschel, BA; Christine Nguyen, BS; Harriet Plaskow, MSW, ACSW, from New York University School of Medicine/Cornell Medical Center, New York, NY; and Holly Clark, MPH; Krystal Hodge, MPH; Goli Vamshidar, MPH; Sivakumar Rangarajan; Zaneta Gaul, MSPH; Ngozi Kamalu, MPH; Bob Yang; Mary Glenn Fowler, MD, from Centers for Disease Control & Prevention, Atlanta, GA.

The Adolescent Impact study was funded by the Centers for Disease Control and Prevention through cooperative agreements with New York University School of Medicine [U64CCU219448]; Children's National Medical Center [U64CCU319459] and University of Maryland School of Medicine [U64CCU319455].