The Effect of Mental Illness, Substance Use, and Treatment for Depression on the Initiation of Highly Active Antiretroviral Therapy among HIV-Infected Individuals

Datos Bibliográficos

ID23325331
AutoresMary K Tegger (University of Washington), Heidi M Crane (0000-0002-3308-7005, University of Washington), Kenneth Tapia (0000-0002-9393-0770, University of Washington), Kenneth A Tapia (University of Washington), Karina K Uldall (Departments of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.), Sarah Holte (0000-0001-7569-3700, University of Washington), Sarah E Holte (University of Washington), Mari M Kitahata (0000-0002-5410-7175, University of Washington)
Año2008
Volumen22
Número3
Páginas233-243
Fecha de publicación2008-03-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAIDS Patient Care and STDs (JOURNAL)
Identificadores de la revistaISSN: 1087-2914 • E-ISSN: 1557-7449
EditorialSAGE Publications (PUBLISHER • US)
DOI10.1089/apc.2007.0092
PMID18290749
OpenAlexW2047450349
IdiomaEN
Citas recibidas58
Referencias citadas55

Information regarding the prevalence of mental illness and substance use among HIV-infected patients and the effect of these problems on HIV treatment is needed. We conducted an observational study of patients in the University of Washington (UW) HIV Cohort to determine prevalence rates for mental illness and substance use. Cox regression analyses were used to examine the relationship between mental illness and substance use, pharmacologic treatment for depression/anxiety, and initiation of highly active antiretroviral therapy (HAART) within 9 months of becoming eligible for HAART. Among 1774 patients in the UW HIV cohort during 2004, 63% had a mental illness (including mood, anxiety, psychotic, or personality disorders), 45% had a substance use disorder, and 38% had both. There were 278 patients who met criteria for HAART eligibility. After controlling for other factors, patients with depression and/or anxiety were significantly less likely to initiate HAART compared with patients without a mental illness (hazard ratio [HR] 0.4, p = 0.02). However, patients with depression/anxiety who received antidepressant/antianxiety medications were equally likely to initiate HAART as patients without a mental illness (HR 0.9, p = 0.5). We found that patients with mental illness or substance use disorders receive HAART at lower CD4+ cell counts and higher HIV-1 RNA levels than patients without these disorders. However, HAART initiation among patients who receive treatment for depression/anxiety is associated with no delay. Screening for these disorders in primary care settings and access to appropriate treatment are increasingly important components of providing care to HIV-infected patients.

Anxiety · Cohort · Depression (economics) · Hazard ratio · Mental health · Mental illness · Mood · Psychiatry · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Internal Medicine · Medicine