title: Improving health outcomes among individuals with HIV, mental illness, and substance use disorders in the Southeast.
abstract: Providing behavioral treatment for mental health and substance use disorders among HIV-infected individuals is critical because these disorders have been associated with negative outcomes such as poorer medication adherence. This study examines the effectiveness of an integrated treatment model for HIV-infected individuals who have both substance use and mental disorders. Study participants (n = 141) were recruited through routine mental health and substance abuse screening at tertiary Infectious Disease clinics in North Carolina. The study participants received integrated mental health and substance abuse treatment for one year and were interviewed at three-month intervals. Using linear regression analyses, we detected statistically significant decreases in participants' psychiatric symptomatology, illicit substance use, alcohol use, and inpatient hospital days. Participants also reported fewer emergency room visits and were more likely to be receiving antiretroviral medications and adequate psychotropic medication regimens at follow-up. No changes in sexual risk, physical health, or medical adherence were detected after treatment participation. This integrated treatment model offers an option for treating HIV-infected individuals with mental health and substance use disorders that can be adapted for use in a variety of psychiatric and medical treatment settings.
authors.affiliation: Center for Health Policy, Law, and Management, Department of Public Policy, Duke University, Durham, NC 27708, USA. Kathryn.whetten@duke.edu
authors.forename: K
authors.initials: K
authors.lastname: Whetten
authors.forename: S
authors.initials: S
authors.lastname: Reif
authors.forename: J
authors.initials: J
authors.lastname: Ostermann
authors.forename: B W
authors.initials: BW
authors.lastname: Pence
authors.forename: M
authors.initials: M
authors.lastname: Swartz
authors.forename: R
authors.initials: R
authors.lastname: Whetten
authors.forename: C
authors.initials: C
authors.lastname: Conover
authors.forename: S
authors.initials: S
authors.lastname: Bouis
authors.forename: N
authors.initials: N
authors.lastname: Thielman
authors.forename: J
authors.initials: J
authors.lastname: Eron
mesh_terms: D000328:Adult; D019033:Delivery of Health Care, Integrated; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance; D019966:Substance-Related Disorders / Q000453:epidemiology*