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HIV Testing Among Adjudicated Adolescents
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Abstracts / 46 (2010) S17–S81
Hispanic adolescents with PCOS had higher levels of cardiac CRP than those without PCOS. Methods: A retrospective chart review of 62 subjects with PCOS and 25 without PCOS was conducted. Systolic and diastolic blood pressure, BMI, total, LDL and HDL cholesterol, triglycerides, fasting and two hour postprandial glucose, fasting and two hour postprandial insulin and cardiac CRP (cCRP) were extracted. HOMA, QUICKI and FGIR indices were calculated. Pearson correlations, independent T-tests for one sample and stepwise forward logistic regression using SPSS software were conducted. Results: There was no difference in age (15.4 6 1.9 vs. 15.2 6 2.5), BMI (33.0 6 5.6 vs. 34.4 6 5.3 kg/m2), cCRP (3.2 6 3.7 vs. 4.1 6 3.8), nor any of the other above parameters, between the PCOS and non-PCOS subjects. Next we correlated each of the above parameters with cCRP in the PCOS and non-PCOS groups and found no correlation within each group. We further subdivided these two groups into overweight PCOS (n ¼ 14, BMI 85-95%), obese PCOS (n ¼ 48, > 95%), overweight non-PCOS (n ¼ 4) and obese non-PCOS (n ¼ 21). There was no significant difference in the cCRP between the two overweight and the two obese subcategories. Disregarding the PCOS status, the total sample was then divided into overweight (n ¼ 18) and obese (n ¼ 69) subjects, and the following factors were found to be statistically different between the groups: systolic BP (114 6 7 vs. 119 6 13, p ¼ .03), fasting insulin (9.9 6 6.1 vs. 16.8 6 11.4, p ¼ .016), HDL (50.7 6 12.9 vs. 42.8 6 9.6, p ¼ .028), cCRP (1.2 6 1.3 vs. 4.1 6 4.0, p ¼ .000), QUICKI (.35 6 .04 vs. .33 6 .04, p ¼ .04), and FGIR (13.93 6 11.4 vs. 7.55 6 5.99, p ¼ .036). Running correlations within each group with cCRP, we found an inverse correlation between cCRP and the HDL cholesterol in the overweight group (-.537, p ¼ .026) and a direct correlation between cCRP and age in years (.295, p ¼ .014), as well as between cCRP and BMI (.273, p ¼ .023) in the obese group. Lastly, we conducted a stepwise forward regression using the entire sample, with cCRP as the dependant variable and only BMI remained in the model at a significance level of p ¼ .010. Conclusions: Contrary to what has been found in adults, in this retrospective study, the cardiac CRP was influenced by the weight status rather than by the presence of PCOS in overweight Hispanic adolescents. Given that age and BMI correlated with cCRP in the obese group, perhaps it is the duration of PCOS that plays a role in the prognosis , and the CRP level may rise in the future in those with PCOS to add to the burden of their weight status. Sources of Support: None.
adolescents (n ¼ 11) and their parents (n ¼ 11) were interviewed and responded to hypothetical scenarios involving genetic testing. Each was paid $20 for their participation. Adolescents were an average of 14.45 years (range 14-17 years) and parents were an average of 42.4 years of age range 31-61 years). The largest ethnic group of participants was non-Hispanic white (45.5%), but the sample also included Hispanics (27.3%), African Americans (18.2%), and one Asian. Audio-tapes were transcribed verbatim and coded for manifest and latent content. Results: None of the adolescents and only three of their parents had heard about the Human Genome Project. Both adolescents and their parents had limited knowledge of the human genome and the risks involved in genetic testing. Most of the adolescents thought genetic testing sounded cool, but this sentiment was not shared by parents. Some of the knowledge of both adolescents and their parents was inaccurate or incomplete. For example, one adolescent responded, I think it s where you prick your finger. One parent thought genetic testing was so couples could pull what they want to pull out of their genetics and make a human. In response to the question, At what age do you think an individual can or should be able to make his or her own decision about genetic testing? adolescents responses ranged from 12 (n ¼ 2) to 21 (n ¼ 2) years. Nine of the 11 (81.8%) parents responded 18. Adolescents were likely to seek additional information from their parents and both groups identified physicians and the Internet as resources for additional information. Both groups would seek more information about how and why genetic testing is done, including its history and benefits. Parents would also consider cost, accuracy of tests results, and credibility of testing site in deciding to have genetic testing. Conclusions: Adolescents are maturing in the Genomic Era and are interested in the potential for genetic testing. Adolescents and their parents need more factual, accurate information and understanding of genetics to make decisions about genetic testing. Findings point to the importance of physicians as a source of credible information for both adolescents and their parents. Findings have implications for developing educational interventions and public policy. Sources of Support: Enhancement grant from Center for Health Promotion and Disease Prevention for Underserved Populations, The University of Texas at Austin School of Nursing [P30NR05051-03S, National Institute of Nursing Research, NIH]. Special Research Grant from the Vice President for Research, The University of Texas at Austin T71MC00003.
139. ADOLESCENTS’ AND THEIR PARENTS’ APPROACHES TO GENETIC TESTING Lynn Rew, EdD, RN, FAAN, Michael Mackert, PhD, Daniel Bonevac, PhD. The University of Texas at Austin Purpose: Direct-to-consumer advertising of genetic testing via the Internet poses potential risks to individuals with limited knowledge about the human genome and without benefit of genetic counseling to make decisions about testing. Adolescents can be both targeted and tempted by such advertising, but we know little about their approach to such opportunities. The purpose of this study was to determine what adolescents and their parents know, what sources they would consult for additional information, and what points they would consider in making decisions about genetic testing. Methods: A qualitative descriptive design was used. The study was approved by an institutional review board for protection of human subjects. After providing informed and written consent/ assent, a multi-ethnic non-probability sample of 22 middle
140. HIV TESTING AMONG ADJUDICATED ADOLESCENTS Rosanne Chien, MS1, Matthew Aalsma, PhD2. 1Indiana University; 2 Indiana University School of Medicine Purpose: Youth in the juvenile justice system engage in sexual risk behavior and are at increased risk for HIV. However, most research exploring sexual risk behavior has been completed with detained, rather than adjudicated, youth. One of 5 adjudicated youth are actually detained, hence adjudicated youth represent a significant group whose sexual risk and HIV testing behavior has been explored much less frequently than detained youth. It is also unknown how willing either adjudicated or detained youth are to be tested for HIV. Lastly, educational background, specifically remaining in school, is an important protective factor and may be a marker of sexual risk behavior through social disconnection. Hence, we will explore the association between those who have and have not been tested for HIV and explore their willingness to get tested in the future. Furthermore, the association between risky
Abstracts / 46 (2010) S17–S81
sexual behavior, HIV testing, and educational background will be analyzed. Methods: Data were obtained from adjudicated adolescents who were recruited while waiting for an appointment with their probation officer or for a scheduled court appearance. Youth completed self-report forms and reported on four items regarding HIV testing, 11 items on risky sexual behaviors, and 2 items pertaining to previous education. The relationships among these measures were assessed using linear regression analysis. Results: 93 respondents were identified (54 male, 39 female). The majority were African American (47%), and the average age was 16.5 years (range: 12-18). Adolescents were asked about their experiences and future desire for HIV testing based on a 4-item scale. On average (mean ¼ 3.39, SD ¼ .84, range 0 - 4), most were in favor of receiving HIV testing. With adjudicated youth, 60% had been tested for HIV in the past. No demographic differences were evident between youth who have and have not been tested (t (86) ¼ 1.102, p ¼ .273). Adolescents who have not been tested for HIV were more likely to report no previous sexual intercourse (t (88) ¼ 5.99, p < .001) compared to adolescents who had previously been tested. Adolescents who had been tested for HIV reported engaging in
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more sexual behaviors (t [89] ¼ 4.46, p < .001) compared to adolescents who had never been tested for HIV. There were no significant differences in willingness to be tested for HIV among those who have and have not been tested in the past. Furthermore, the vast majority of youth (96%; both those who have been and have not been tested) were willing to be tested for HIV in the future. We also found that adolescents who are currently in school significantly predicted decreased risky sexual behavior (b ¼ -.81, t [93] ¼ -2.35, p < .05). Conclusions: Previous research has indicated that youth in the juvenile justice system have increased sexual risk behavior and HIV. However, there is limited information on adolescents’ history of HIV testing and their willingness to get tested for HIV in the future. This high rate of willingness to be tested for HIV demonstrates the need for HIV tested for youth in the juvenile justice system and the possibility of expanding HIV testing to adjudicated, not only detained, youth. Lastly, enrollment in school is a protective factor in terms of sexual risk behavior. Sources of Support: Center for AIDS Research; HRSA/MCHB T710008.
Abstracts / 46 (2010) S17–S81
Hispanic adolescents with PCOS had higher levels of cardiac CRP than those without PCOS. Methods: A retrospective chart review of 62 subjects with PCOS and 25 without PCOS was conducted. Systolic and diastolic blood pressure, BMI, total, LDL and HDL cholesterol, triglycerides, fasting and two hour postprandial glucose, fasting and two hour postprandial insulin and cardiac CRP (cCRP) were extracted. HOMA, QUICKI and FGIR indices were calculated. Pearson correlations, independent T-tests for one sample and stepwise forward logistic regression using SPSS software were conducted. Results: There was no difference in age (15.4 6 1.9 vs. 15.2 6 2.5), BMI (33.0 6 5.6 vs. 34.4 6 5.3 kg/m2), cCRP (3.2 6 3.7 vs. 4.1 6 3.8), nor any of the other above parameters, between the PCOS and non-PCOS subjects. Next we correlated each of the above parameters with cCRP in the PCOS and non-PCOS groups and found no correlation within each group. We further subdivided these two groups into overweight PCOS (n ¼ 14, BMI 85-95%), obese PCOS (n ¼ 48, > 95%), overweight non-PCOS (n ¼ 4) and obese non-PCOS (n ¼ 21). There was no significant difference in the cCRP between the two overweight and the two obese subcategories. Disregarding the PCOS status, the total sample was then divided into overweight (n ¼ 18) and obese (n ¼ 69) subjects, and the following factors were found to be statistically different between the groups: systolic BP (114 6 7 vs. 119 6 13, p ¼ .03), fasting insulin (9.9 6 6.1 vs. 16.8 6 11.4, p ¼ .016), HDL (50.7 6 12.9 vs. 42.8 6 9.6, p ¼ .028), cCRP (1.2 6 1.3 vs. 4.1 6 4.0, p ¼ .000), QUICKI (.35 6 .04 vs. .33 6 .04, p ¼ .04), and FGIR (13.93 6 11.4 vs. 7.55 6 5.99, p ¼ .036). Running correlations within each group with cCRP, we found an inverse correlation between cCRP and the HDL cholesterol in the overweight group (-.537, p ¼ .026) and a direct correlation between cCRP and age in years (.295, p ¼ .014), as well as between cCRP and BMI (.273, p ¼ .023) in the obese group. Lastly, we conducted a stepwise forward regression using the entire sample, with cCRP as the dependant variable and only BMI remained in the model at a significance level of p ¼ .010. Conclusions: Contrary to what has been found in adults, in this retrospective study, the cardiac CRP was influenced by the weight status rather than by the presence of PCOS in overweight Hispanic adolescents. Given that age and BMI correlated with cCRP in the obese group, perhaps it is the duration of PCOS that plays a role in the prognosis , and the CRP level may rise in the future in those with PCOS to add to the burden of their weight status. Sources of Support: None.
adolescents (n ¼ 11) and their parents (n ¼ 11) were interviewed and responded to hypothetical scenarios involving genetic testing. Each was paid $20 for their participation. Adolescents were an average of 14.45 years (range 14-17 years) and parents were an average of 42.4 years of age range 31-61 years). The largest ethnic group of participants was non-Hispanic white (45.5%), but the sample also included Hispanics (27.3%), African Americans (18.2%), and one Asian. Audio-tapes were transcribed verbatim and coded for manifest and latent content. Results: None of the adolescents and only three of their parents had heard about the Human Genome Project. Both adolescents and their parents had limited knowledge of the human genome and the risks involved in genetic testing. Most of the adolescents thought genetic testing sounded cool, but this sentiment was not shared by parents. Some of the knowledge of both adolescents and their parents was inaccurate or incomplete. For example, one adolescent responded, I think it s where you prick your finger. One parent thought genetic testing was so couples could pull what they want to pull out of their genetics and make a human. In response to the question, At what age do you think an individual can or should be able to make his or her own decision about genetic testing? adolescents responses ranged from 12 (n ¼ 2) to 21 (n ¼ 2) years. Nine of the 11 (81.8%) parents responded 18. Adolescents were likely to seek additional information from their parents and both groups identified physicians and the Internet as resources for additional information. Both groups would seek more information about how and why genetic testing is done, including its history and benefits. Parents would also consider cost, accuracy of tests results, and credibility of testing site in deciding to have genetic testing. Conclusions: Adolescents are maturing in the Genomic Era and are interested in the potential for genetic testing. Adolescents and their parents need more factual, accurate information and understanding of genetics to make decisions about genetic testing. Findings point to the importance of physicians as a source of credible information for both adolescents and their parents. Findings have implications for developing educational interventions and public policy. Sources of Support: Enhancement grant from Center for Health Promotion and Disease Prevention for Underserved Populations, The University of Texas at Austin School of Nursing [P30NR05051-03S, National Institute of Nursing Research, NIH]. Special Research Grant from the Vice President for Research, The University of Texas at Austin T71MC00003.
139. ADOLESCENTS’ AND THEIR PARENTS’ APPROACHES TO GENETIC TESTING Lynn Rew, EdD, RN, FAAN, Michael Mackert, PhD, Daniel Bonevac, PhD. The University of Texas at Austin Purpose: Direct-to-consumer advertising of genetic testing via the Internet poses potential risks to individuals with limited knowledge about the human genome and without benefit of genetic counseling to make decisions about testing. Adolescents can be both targeted and tempted by such advertising, but we know little about their approach to such opportunities. The purpose of this study was to determine what adolescents and their parents know, what sources they would consult for additional information, and what points they would consider in making decisions about genetic testing. Methods: A qualitative descriptive design was used. The study was approved by an institutional review board for protection of human subjects. After providing informed and written consent/ assent, a multi-ethnic non-probability sample of 22 middle
140. HIV TESTING AMONG ADJUDICATED ADOLESCENTS Rosanne Chien, MS1, Matthew Aalsma, PhD2. 1Indiana University; 2 Indiana University School of Medicine Purpose: Youth in the juvenile justice system engage in sexual risk behavior and are at increased risk for HIV. However, most research exploring sexual risk behavior has been completed with detained, rather than adjudicated, youth. One of 5 adjudicated youth are actually detained, hence adjudicated youth represent a significant group whose sexual risk and HIV testing behavior has been explored much less frequently than detained youth. It is also unknown how willing either adjudicated or detained youth are to be tested for HIV. Lastly, educational background, specifically remaining in school, is an important protective factor and may be a marker of sexual risk behavior through social disconnection. Hence, we will explore the association between those who have and have not been tested for HIV and explore their willingness to get tested in the future. Furthermore, the association between risky
Abstracts / 46 (2010) S17–S81
sexual behavior, HIV testing, and educational background will be analyzed. Methods: Data were obtained from adjudicated adolescents who were recruited while waiting for an appointment with their probation officer or for a scheduled court appearance. Youth completed self-report forms and reported on four items regarding HIV testing, 11 items on risky sexual behaviors, and 2 items pertaining to previous education. The relationships among these measures were assessed using linear regression analysis. Results: 93 respondents were identified (54 male, 39 female). The majority were African American (47%), and the average age was 16.5 years (range: 12-18). Adolescents were asked about their experiences and future desire for HIV testing based on a 4-item scale. On average (mean ¼ 3.39, SD ¼ .84, range 0 - 4), most were in favor of receiving HIV testing. With adjudicated youth, 60% had been tested for HIV in the past. No demographic differences were evident between youth who have and have not been tested (t (86) ¼ 1.102, p ¼ .273). Adolescents who have not been tested for HIV were more likely to report no previous sexual intercourse (t (88) ¼ 5.99, p < .001) compared to adolescents who had previously been tested. Adolescents who had been tested for HIV reported engaging in
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more sexual behaviors (t [89] ¼ 4.46, p < .001) compared to adolescents who had never been tested for HIV. There were no significant differences in willingness to be tested for HIV among those who have and have not been tested in the past. Furthermore, the vast majority of youth (96%; both those who have been and have not been tested) were willing to be tested for HIV in the future. We also found that adolescents who are currently in school significantly predicted decreased risky sexual behavior (b ¼ -.81, t [93] ¼ -2.35, p < .05). Conclusions: Previous research has indicated that youth in the juvenile justice system have increased sexual risk behavior and HIV. However, there is limited information on adolescents’ history of HIV testing and their willingness to get tested for HIV in the future. This high rate of willingness to be tested for HIV demonstrates the need for HIV tested for youth in the juvenile justice system and the possibility of expanding HIV testing to adjudicated, not only detained, youth. Lastly, enrollment in school is a protective factor in terms of sexual risk behavior. Sources of Support: Center for AIDS Research; HRSA/MCHB T710008.