Two associate professors, Megan Quinn and Shimin Zheng, and doctoral student Elaine Loudermilk are beginning a study in ETSU’s College of Public Health’s Department of Biostatistics and Epidemiology to assess how adverse childhood experiences affect a patient’s HIV medication adherence.
This project will be a part of Loudermilk’s doctoral dissertation as she will be working hands-on with the patients inside ETSU’s Center of Excellence for HIV/AIDS.
“The study is going to help to get a better understanding [of] if certain ACEs have led to barriers of care,” said Loudermilk. “So, that could result with mental health and could interfere with getting to appointments, or wanting to stay in care to stay on their medication as prescribed.”
Loudermilk says that the grant helps give patients in the clinic an incentive to help develop a questionnaire for the clinic providers to use. The World Health Organization uses an ACE questionnaire, and some of those questions have been combined in the interview so that participants can report if they are appropriate or relevant.
According to Quinn, southern Appalachia has a higher HIV prevalence than other parts of Appalachia, and people living with HIV/AIDS have reported ACEs and substance abuse as reasons for not adhering to treatment.
“The original study for ACEs was in the late 90s and it looked at various types of abuse and dysfunction that happened before the age of 18,” said Quinn. “The study looked at physical, sexual, emotional and verbal abuse and household dysfunction. The dysfunction in the household may not directly relate to the child but is indirectly impacting the child.”
According to Loudermilk, there have been studies done on specific ACEs that have linked correlations from childhood trauma to how it affects the ability to want to take care of oneself, self-esteem and value.
“Ultimately, the goal with this questionnaire is to have something that can, at least, help providers understand what their patients are going through individually and as a population, and hopefully it will help flag individuals who may be at risk for falling out of care so that care can be better tailored to that individual,” said Loudermilk.
Quinn also says that a hopeful outcome of the research is for the clinic to be able to administer the questionnaire to someone as they are coming in for treatment, and if certain ACEs present, patients can be followed up with extra individualized care.
Quinn, Loudermilk and Zheng plan to have the data collection finished by the end of May, and have both the grant and Loudermilk’s dissertation finished by the end of June.
To learn more about the Center of Excellence for HIV/AIDS, visit www.etsu.edu/com/coe-hiv.
