Child and Adolescent Self-Awareness and Health (CASAH)
National Institute of Mental Health (NIMH)
Jacobi Medical Center
New York, NY, USA
Growing numbers of perinatally HIV-infected (PHIV+) or HIV-exposed, but uninfected (PHIV–) youth are approaching young adulthood, an age increasingly recognized as one of the most challenging transition periods as youth begin to assume adult responsibilities and establish patterns of positive and risky health behaviors that carry through to later life. PHIV+ young adults are making critical choices about treatment, sex, relationships, and child-bearing having grown up with a chronic sexually transmittable virus. CASAH examines extended behavioral health trajectories from childhood to young adulthood, theoretically informed and modifiable predictors of these trajectories and young adult transitions, and the role of HIV, critical to much needed intervention development.
CASAH 3 is a competing continuation of Child and Adolescent Self-awareness and Health study (NIMHR01-MH6913, CASAH 1 and 2), in which we have prospectively followed PHIV+ and PHIV– youth across older childhood and adolescence, collecting data informed by our theoretical model, Social Action Theory (SAT) on individual, family, social, and contextual determinants of behavioral health. Participants were originally recruited at ages 9-16 years from four medical centers in NYC. In CASAH 1, we collected data on youth and their caregivers at two time points, 18 months apart, and in CASAH 2, we followed the youth into older adolescence at three additional time points, one year apart. In CASAH 3, young adults, ages 18-26 years, are being re-recruited and interviewed at three annual visits. In addition, multiple indicators of adherence are being utilized, including monthly, unannounced phone-based pill counts, self-reports, and medical record data.CASAH-3 will result in a 12-year profile of the psychosocial determinants of behavioral health in PHIV+ and PHIV– youth., including: 1) the impact of HIV infection on behavioral health (mental health, sexual and substance use risk behavior) and transitions in young adulthood; 2) how critical risk and protective factors from earlier developmental stages, drawn from SAT, as well as a risk and resilience framework affect young adult behavioral health and transitions; 3) trajectories of behavioral health across adolescence and the influence of these trajectories on young adult transitions; and 4) (among PHIV+ youth) influences on adherence to ART and health care over time.
- Raymond J, Bucek A, Dolezal C, Warne P, Benson S, Abrams EJ, Elkington KS, Kalichman S, Kalichman M, Mellins, CA. (2017). Feasibility and Utility of Unannounced Telephone Pill Counts to Measure Medication Adherence Among Perinatally HIV-infected Adolescents and Young Adults. J Pediatr Psychol, 42(9):1006-1015
Weintraub A, Mellins CA, Warne P, Dolezal C, Elkington KS, Bucek A, Leu CS, Bamji M, Wiznia A, Abrams EJ. Patterns and correlates of serostatus disclosure to sexual partners by perinatally-infected adolescents and young adults. AIDS and Behavior, 21(1):129-140.
Mutumba, M, Bauermeister JA , Elkington KS , Bucek A, Dolezal C, Leu CS, Mellins CA. (2017). Changes in substance use symptoms across adolescence in youth perinatally infected with HIV. AIDS and Behavior, 21(4):1117-1128.
Mutumba M, Bauermeister JA , Elkington KS , Bucek A, Dolezal C, Leu CS, Mellins CA. (2016). A prospective longitudinal study of mental health symptoms among perinatally HIV-infected and HIV-exposed but uninfected urban youths. J Adolesc Health, 58(4): 460–466.
Elkington KS, Cruz J, Dolezal C, Leu CS, Mellins CA. (2016). Marijuana use and psychiatric disorders in perinatally HIV-infected youth: Does HIV matter? Journal of Pediatric Psychology, 41(3):277-286.
Gromadzka O, Santamaria EK, Benavides JM, Dolezal C, Elkington KS, Leu CS, McKay M, Abrams EJ, Wiznia A, Bamji M, Mellins CA. (2015). Sexual health knowledge in a sample of perinatally HIV-infected and perinatally-exposed uninfected youth. J HIV/AIDS and Social Serivces; 14(3); 277-293
Elkington KS, Bauermeister, JA, Santamaria EK, Dolezal C, Mellins CA. (2015). Substance use and the development of sexual risk behaviors in youth with perinatal HIV infection. J Pediatr Psycho, 40(4):442-454.
Evans SD, Mellins CA, Leu CS, Elkington KS, Warne P, Dolezal C, Santamaria EK, Wiznia A, Bamji M, Jurgrau A, Abrams EJ. (2015). HIV treatment adherence measurement and reporting concordance in youth with perinatally acquired HIV infection and their caregivers. AIDS Patient Care STDS, 29(1):43-51.
Dolezal C, Warne P, Santamaria EK, Elkington KS, Benavides JM, Mellins CA. (2014). Asking only "Did you use a condom?" underestimates the prevalence of unprotected sex among PHIV+ and PHIV- youth. J Sex Res, 51:599-604.
Pearlstein SL, Mellins CA, Dolezal C, Elkington KS, Santamaria EK, Leu CS, Abrams EJ. (2013). Youth in transition: Life skills among perinatally HIV-infected and HIV-exposed adolescents. J Pediatr Psycho, 39(3):294-305.
Elkington KS, Bauermeister JA, Robbins RN, Gromadzka O, Abrams EJ, Wiznia A, Bamji M, Mellins CA. (2012). Individual and contextual factors of sexual risk behavior in youth perinatally-infected with HIV. AIDS Patient Care STDS, 26:411-422.