Substance abuse and symptoms of mental illness among HIV-positive persons in the Southeast.
OBJECTIVE
Mental illness and substance abuse have been consistently associated with poor HIV-medication adherence and other negative health outcomes.


METHODS
A brief mental health and substance use screening instrument was administered to 1,362 HIV-infected individuals receiving care at two academic medical center Infectious Diseases Clinics in North Carolina.


RESULTS
Study results indicated high frequencies of symptoms of mental illness (60%), substance abuse (32%), and co-occurring symptoms of mental illness and substance abuse (23%). Younger age (P = 0.03), male sex (P < 0.001), and higher viral load (P < 0.001) were associated with substance use problems. White race (P = 0.001), younger age (P = 0.023), and higher viral load (P = 0.042) were associated with symptoms of mental illness.


CONCLUSIONS
In the Southeast, mental health and substance abuse services are sparse and stigma is high; thus, innovative treatment strategies are needed to address the high levels of co-occurring mental illness and substance abuse. Antiretroviral therapies will not reach their potential for slowing the HIV/AIDS epidemic and prolonging survival if comorbidities that influence patient behavior are not addressed.
Whetten
Kathryn
K
Department of Public Policy, Duke University, Durham, NC, USA.
Reif
Susan S
SS
Napravnik
Sonia
S
Swartz
Marvin S
MS
Thielman
Nathan M
NM
Eron
Joseph J
JJ
Lowe
Kristin
K
Soto
Tomas
T
D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications*; D001523:Mental Disorders / Q000453:epidemiology*; D015995:Prevalence; D015144:Southeastern United States / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*