title: Factors associated with psychotherapy longevity among HIV-positive patients.
abstract: Mental health concerns are salient to many HIV-positive individuals, yet, there are also numerous challenges with regard to access and retention in care. The present study sought to investigate factors that are associated with longevity in outpatient psychological care for HIV-positive patients. We aimed to better understand what factors (e.g., race, gender, age, history of mental health service utilization) are associated with the length of participation in psychotherapy in our clinic. This is an archival study consisting of chart review of our clinical documentation related to the psychological services provided in our clinic from January 2005 through December 2007. Eligible charts included all HIV-positive individuals seeking psychotherapy in the Department of Psychiatry and Health Behavior at the Medical College of Georgia (n = 87 records; 33.3% female; 52.9% ethnic minority, 57% sexual minority, middle-aged (42.0 years +/- 9.6 years). Results indicated that the presence of cohabitating social support distinguished between those who continued or terminated after the intake session, with social support being associated with continuation after intake. Furthermore, shorter distance from clinic, history of previous psychotherapy, concurrent pharmacotherapy, comorbid personality disorder diagnosis, and having an ethnic minority provider were associated with greater longevity in treatment. As a result of modest sample size relative to the number of predictor variables, analyses utilized multiple bivariate analyses and thus, results must be considered preliminary and should be replicated in a larger investigation. However, treatment providers may utilize these initial findings to improve retention in care and to improve the quality of mental health care provided to HIV-positive outpatients.
authors.affiliation: Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta, Georgia 30912, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Bottonari
authors.forename: Lara M
authors.initials: LM
authors.lastname: Stepleman
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D005845:Georgia; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance; D011613:Psychotherapy / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents