Original Article
Substance Abuse and Symptoms of Mental Illness Among HIV-positive Persons in the Southeast
Abstract
Objectives: 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.
Key Points
* Mental illness and substance abuse have been associated with poor HIV-medication adherence, which may result in treatment failure or poorer health outcomes.
* This study found a high prevalence of symptoms of mental health (60%) and substance abuse (32%) comorbidities in a population of HIV-positive patients receiving care in the Southeast.
* Such comorbidities should be addressed to improve HIV treatment outcomes.
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