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The influence of religious beliefs and practices on health care decision-making among HIV positive adolescents.

  • Lyon, Maureen E1, 2, 3
  • D'Angelo, Lawrence J1, 3
  • Cheng, Yao I4
  • Dallas, Ronald H5
  • Garvie, Patricia A6
  • Wang, Jichuan4
  • 1 Division of Adolescent and Young Adult Medicine, Children's National , Washington , DC , USA.
  • 2 Center for Translational Science/Children's Research Institute , Washington , DC , USA.
  • 3 George Washington University School of Medicine and Health Sciences , Washington , DC , USA.
  • 4 Division of Biostatistics and Study Methodology, Center for Translational Science/Children's Research Institute, Children's National , Washington , DC , USA.
  • 5 Department of Infectious Diseases, St. Jude Children's Research Hospital , Memphis , TN , USA.
  • 6 Research Department, Children's Diagnostic & Treatment Center , Fort Lauderdale , FL , USA.
Published Article
AIDS care
Publication Date
Sep 19, 2019
DOI: 10.1080/09540121.2019.1668523
PMID: 31535560


It is unknown if religiousness/spirituality influences end-of-life treatment preferences among adolescents. Investigators assessed whether religiousness/spirituality moderates the relationship between an advance care planning intervention and end-of-life treatment preferences among 85 primarily African-American adolescents living with HIV/AIDS in outpatient-hospital-based HIV-specialty clinics in the United States. Adolescents aged 14-21 years living with HIV/AIDS and their families were randomized to three-weekly-60-minute sessions either: advance care planning (survey, goals of care conversation, advance directive); or control (developmental history, safety tips, nutrition/exercise). At 3-months post-intervention the intervention effect (decreasing the likelihood of choosing to continue treatments in all situations) was significantly moderated by religiousness/spirituality. Highly religious/spiritual adolescents were four times more likely to choose to continue treatments in all situations. Thus, intensive treatments at end-of-life may represent health equity, rather than health disparity. The belief believed that HIV is a punishment from God at baseline (15%, 14/94) was not associated with end-of-life treatment preferences. Twelve percent (11/94) reported they had stopped taking HIV medications for more than 3 days because of the belief in a miracle. Religiousness moderates adolescent's medical decision-making. Adolescents who believe in miracles should receive chaplaincy referrals to help maintain medication adherence.

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