title: The impact of mental health and substance abuse factors on HIV prevention and treatment.
abstract: The convergence of HIV, substance abuse (SA), and mental illness (MI) represents a distinctive challenge to health care providers, policy makers, and researchers. Previous research with the mentally ill and substance-abusing populations has demonstrated high rates of psychiatric and general medical comorbidity. Additionally, persons living with HIV/AIDS have dramatically elevated rates of MI and other physical comorbidities. This pattern of co-occurring conditions has been described as a syndemic. Syndemic health problems occur when linked health problems involving 2 or more afflictions interact synergistically and contribute to the excess burden of disease in a population. Evidence for syndemics arises when health-related problems cluster by person, place, or time. This article describes a research agenda for beginning to understand the complex relations among MI, SA, and HIV and outlines a research agenda for the Social and Behavioral Science Research Network in these areas.
authors.affiliation: Institute for Health, Health Care Policy, and Aging Research, and the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ 90801, USA. jamie.walkup@gmail.com
authors.forename: James
authors.initials: J
authors.lastname: Walkup
authors.forename: Michael B
authors.initials: MB
authors.lastname: Blank
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gonzalez
authors.forename: Steven
authors.initials: S
authors.lastname: Safren
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schwartz
authors.forename: Larry
authors.initials: L
authors.lastname: Brown
authors.forename: Ira
authors.initials: I
authors.lastname: Wilson
authors.forename: Amy
authors.initials: A
authors.lastname: Knowlton
authors.forename: Frank
authors.initials: F
authors.lastname: Lombard
authors.forename: Cynthia
authors.initials: C
authors.lastname: Grossman
authors.forename: Karen
authors.initials: K
authors.lastname: Lyda
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schumacher
mesh_terms: D003140:Communicable Disease Control / Q000379:methods; D015897:Comorbidity; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D015438:Health Behavior; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D010349:Patient Compliance; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome