September #39 : Youth on Drugs - by Lark Lands, PhD

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Table of Contents

Talking 'Bout Their Generation

Youth to Youth

Bargaining Power

Growing Up in Public

Liver Worst

Family Tree

Blood Lines

S.O.S.

To the Editor

And on the 7th Day...

In the Sack

Vertex Vortex

Pump and Grind

Baby Gap

You Can’t Touch This

Aloe Can You Go?

Death by Bureaucracy

Bubonic Tonic

Say What

Say What

All Apologies

Plenty of Nothing

Rough Cuts

POZ Picks

Spin and Needles

No Miss Manners

HIV Confidential

Making a Scene

Obits

Presidential Nemesis

Are the Kids Alright?

Kid Gloves

Prime-Time Lives

Don’t Make Me Over

Confessions of a Jerk

Life Lessons

Quality Time

Valuable Kitchen Tool

Better Safe Than Sushi

The Heart of the Matter

To C or Not to C

The Circle Game

Youth on Drugs

Uncertain-teens

Making the Grade

Finger on the Pulses

Fountain of Youth

Where to find it

Reality Check

Leftovers



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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September 1998

Youth on Drugs

by Lark Lands, PhD

For adolescents taking antiretrovirals, counseling and peer support for adherence are key

Teens taking antiretroviral meds share with adults all the problems of keeping HIV in check long-term—sweating out side effects and adhering to a precise pill-popping schedule they must stick with day in and day out for the long haul. But for many adolescents, yet another trouble is the real biggie: Being different from their friends.

Among teenagers, anything that makes you unlike your buddies is a bad thing. So gulping gobs of pills several times a day—which will certainly make someone stand out from the crowd—is tough. And that may also out you as HIV positive—even tougher.

The alternative—hiding HIV status and the meds that go with it—is also more difficult for teenagers. Neal Hoffman, MD, medical director of the Adolescent AIDS Program at Montefiore Medical Center in New York City, says: “Their worlds are smaller. Try to figure out how to incorporate meds into the life of a kid who’s on the bus at 7:30 am and doesn’t get home until evening because of after-school activities.”

In the end, it seems like a lot of teens can’t figure it out. Hoffman says that even the kids who are willing to try the meds often fail to sustain their regimens for more than a few weeks. The key, he believes, is careful preparation: “Day One is not telling these teens that they have to start taking drugs now. Instead, it’s the beginning of a series of sessions teaching them what the meds may do for them, what they look like, how taking them can be integrated into their lives, and so on.”


Hoffman notes that such preparation is particularly important for younger teens who may find it very difficult to do an accurate risk/benefit analysis. “It’s hard for them to see that taking meds now—with all the side effects and problems that may come with them—is worth it because of the possible future benefit of avoiding disease progression and illness. And some feel that not taking the pills will magically mean that they don’t really have the disease.”

The high rate of  teen nonadherence has taught Hoffman and his colleagues that what’s key is helping adolescents gain skills and confidence in life management and self-care. With that often comes a belief in their ability to stick to their drug regimens. So support groups and buddy systems are an integral part of the Montefiore program. For teens, seeing how their friends do it and getting that crucial peer support may be a big boost toward success—and, as with adult groups, a great way to deliver the latest info on AIDS care.




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