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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.

Publication ,  Journal Article
Weaver, MR; Conover, CJ; Proescholdbell, RJ; Arno, PS; Ang, A; Ettner, SL ...
Published in: J Acquir Immune Defic Syndr
April 1, 2008

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.

Duke Scholars

Published In

J Acquir Immune Defic Syndr

DOI

ISSN

1525-4135

Publication Date

April 1, 2008

Volume

47

Issue

4

Start / End Page

449 / 458

Location

United States

Related Subject Headings

  • White People
  • Virology
  • United States
  • Surveys and Questionnaires
  • Substance-Related Disorders
  • Substance Abuse Treatment Centers
  • Socioeconomic Factors
  • Models, Theoretical
  • Middle Aged
  • Mental Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Weaver, M. R., Conover, C. J., Proescholdbell, R. J., Arno, P. S., Ang, A., Ettner, S. L., & Cost Subcommittee of the HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study Group, . (2008). 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, 47(4), 449–458. https://doi.org/10.1097/QAI.0b013e3181642244
Weaver, Marcia R., Christopher J. Conover, Rae Jean Proescholdbell, Peter S. Arno, Alfonso Ang, Susan L. Ettner, and Susan L. Cost Subcommittee of the HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study Group. “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 47, no. 4 (April 1, 2008): 449–58. https://doi.org/10.1097/QAI.0b013e3181642244.
Weaver MR, Conover CJ, Proescholdbell RJ, Arno PS, Ang A, Ettner SL, 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.
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.J Acquir Immune Defic Syndr, vol. 47, no. 4, Apr. 2008, pp. 449–58. Pubmed, doi:10.1097/QAI.0b013e3181642244.
Weaver MR, Conover CJ, Proescholdbell RJ, Arno PS, Ang A, Ettner SL, Cost Subcommittee of the HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study Group. 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):449–458.

Published In

J Acquir Immune Defic Syndr

DOI

ISSN

1525-4135

Publication Date

April 1, 2008

Volume

47

Issue

4

Start / End Page

449 / 458

Location

United States

Related Subject Headings

  • White People
  • Virology
  • United States
  • Surveys and Questionnaires
  • Substance-Related Disorders
  • Substance Abuse Treatment Centers
  • Socioeconomic Factors
  • Models, Theoretical
  • Middle Aged
  • Mental Health Services