title: Substance abuse and symptoms of mental illness among HIV-positive persons in the Southeast.
abstract: 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.
authors.affiliation: Department of Public Policy, Duke University, Durham, NC, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Whetten
authors.forename: Susan S
authors.initials: SS
authors.lastname: Reif
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.forename: Marvin S
authors.initials: MS
authors.lastname: Swartz
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Thielman
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Eron
authors.forename: Kristin
authors.initials: K
authors.lastname: Lowe
authors.forename: Tomas
authors.initials: T
authors.lastname: Soto
mesh_terms: 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*