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Utilization of mental health and substance abuse care for people living with HIV/AIDS, chronic mental illness, and substance abuse disorders.
J Acquir Immune Defic Syndr. 2008 Apr 01; 47(4):449-58.JA

Abstract

OBJECTIVE

To examine the effects of race/ethnicity, insurance, and type of substance abuse (SA) diagnosis on utilization of mental health (MH) and SA services among triply diagnosed adults with HIV/AIDS and co-occurring mental illness (MI) and SA disorders.

DATA SOURCE

Baseline (2000 to 2002) data from the HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study.

STUDY DESIGN

A multiyear cooperative agreement with 8 study sites in the United States. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was administered by trained interviewers to determine whether or not adults with HIV/AIDS had co-occurring MI and SA disorders.

DATA COLLECTION/EXTRACTION METHODS

Subjects were interviewed in person about their personal characteristics and utilization of MH and SA services in the prior 3 months. Data on HIV viral load were abstracted from their medical records.

PRINCIPAL FINDINGS

Only 33% of study participants received concurrent treatment for MI and SA, despite meeting diagnostic criteria for both: 26% received only MH services, 15% received only SA services, and 26% received no services. In multinomial logistic analysis, concurrent utilization of MH and SA services was significantly lower among nonwhite and Hispanic participants as a group and among those who were not dependent on drugs and alcohol. Concurrent utilization was significantly higher for people with Veterans Affairs Civilian Health and Medical Program of the Uniformed Services (VA CHAMPUS) insurance coverage. Two-part models were estimated for MH outpatient visits and 3 SA services: (1) outpatient, (2) residential, and (3) self-help groups. Binary logistic regression was estimated for any use of psychiatric drugs. Nonwhites and Hispanics as a group were less likely to use 3 of the 5 services; they were more likely to attend SA self-help groups. Participants with insurance were significantly more likely to receive psychiatric medications and residential SA treatment. Those with Medicaid were more likely to receive MH outpatient services. Participants who were alcohol dependent but not drug dependent were significantly less likely to receive SA services than those with dual alcohol and drug dependence.

CONCLUSION

Among adults with HIV/AIDS and co-occurring MH and SA disorders, utilization of MH and SA services needs to be improved.

Authors+Show Affiliations

Department of Health Services, University of Washington, Seattle, WA, USA. mweaver@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18197121

Citation

Weaver, Marcia R., et al. "Utilization of Mental Health and Substance Abuse Care for People Living With HIV/AIDS, Chronic Mental Illness, and Substance Abuse Disorders." Journal of Acquired Immune Deficiency Syndromes (1999), vol. 47, no. 4, 2008, pp. 449-58.
Weaver MR, Conover CJ, Proescholdbell RJ, et al. Utilization of mental health and substance abuse care for people living with HIV/AIDS, chronic mental illness, and substance abuse disorders. J Acquir Immune Defic Syndr. 2008;47(4):449-58.
Weaver, M. R., Conover, C. J., Proescholdbell, R. J., Arno, P. S., Ang, A., & Ettner, S. L. (2008). Utilization of mental health and substance abuse care for people living with HIV/AIDS, chronic mental illness, and substance abuse disorders. Journal of Acquired Immune Deficiency Syndromes (1999), 47(4), 449-58. https://doi.org/10.1097/QAI.0b013e3181642244
Weaver MR, et al. Utilization of Mental Health and Substance Abuse Care for People Living With HIV/AIDS, Chronic Mental Illness, and Substance Abuse Disorders. J Acquir Immune Defic Syndr. 2008 Apr 1;47(4):449-58. PubMed PMID: 18197121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utilization of mental health and substance abuse care for people living with HIV/AIDS, chronic mental illness, and substance abuse disorders. AU - Weaver,Marcia R, AU - Conover,Christopher J, AU - Proescholdbell,Rae Jean, AU - Arno,Peter S, AU - Ang,Alfonso, AU - Ettner,Susan L, AU - ,, PY - 2008/1/17/pubmed PY - 2008/5/13/medline PY - 2008/1/17/entrez SP - 449 EP - 58 JF - Journal of acquired immune deficiency syndromes (1999) JO - J Acquir Immune Defic Syndr VL - 47 IS - 4 N2 - OBJECTIVE: To examine the effects of race/ethnicity, insurance, and type of substance abuse (SA) diagnosis on utilization of mental health (MH) and SA services among triply diagnosed adults with HIV/AIDS and co-occurring mental illness (MI) and SA disorders. DATA SOURCE: Baseline (2000 to 2002) data from the HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study. STUDY DESIGN: A multiyear cooperative agreement with 8 study sites in the United States. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was administered by trained interviewers to determine whether or not adults with HIV/AIDS had co-occurring MI and SA disorders. DATA COLLECTION/EXTRACTION METHODS: Subjects were interviewed in person about their personal characteristics and utilization of MH and SA services in the prior 3 months. Data on HIV viral load were abstracted from their medical records. PRINCIPAL FINDINGS: Only 33% of study participants received concurrent treatment for MI and SA, despite meeting diagnostic criteria for both: 26% received only MH services, 15% received only SA services, and 26% received no services. In multinomial logistic analysis, concurrent utilization of MH and SA services was significantly lower among nonwhite and Hispanic participants as a group and among those who were not dependent on drugs and alcohol. Concurrent utilization was significantly higher for people with Veterans Affairs Civilian Health and Medical Program of the Uniformed Services (VA CHAMPUS) insurance coverage. Two-part models were estimated for MH outpatient visits and 3 SA services: (1) outpatient, (2) residential, and (3) self-help groups. Binary logistic regression was estimated for any use of psychiatric drugs. Nonwhites and Hispanics as a group were less likely to use 3 of the 5 services; they were more likely to attend SA self-help groups. Participants with insurance were significantly more likely to receive psychiatric medications and residential SA treatment. Those with Medicaid were more likely to receive MH outpatient services. Participants who were alcohol dependent but not drug dependent were significantly less likely to receive SA services than those with dual alcohol and drug dependence. CONCLUSION: Among adults with HIV/AIDS and co-occurring MH and SA disorders, utilization of MH and SA services needs to be improved. SN - 1525-4135 UR - https://www.unboundmedicine.com/medline/citation/18197121/Utilization_of_mental_health_and_substance_abuse_care_for_people_living_with_HIV/AIDS_chronic_mental_illness_and_substance_abuse_disorders_ L2 - https://doi.org/10.1097/QAI.0b013e3181642244 DB - PRIME DP - Unbound Medicine ER -