The HIV/AIDS epidemic is a significant public health concern
in North Carolina, and previous research has pointed to elevated mental health
distress and substance use among HIV-infected populations, which may impact
patients' adherence to medications. The aims of this study were to describe the
prevalence of mental health and substance use issues among patients of a North
Carolina HIV clinic, to examine differences by demographic characteristics, and
to examine factors associated with suboptimal adherence to HIV medications.
This study was a secondary analysis of clinical data
routinely collected through a health behavior questionnaire at a large HIV
clinic in North Carolina. We analyzed data collected from February 2011 to
August 2012.
The sample included 1,398 patients. Overall, 12.2% of
patients endorsed current symptomology indicative of moderate or severe levels
of depression, and 38.6% reported receiving a psychiatric diagnosis at some
point in their life. Additionally, 19.1% had indications of current problematic
drinking, and 8.2% reported problematic drug use. Nearly one-quarter (22.1%)
reported suboptimal adherence to HIV medications. Factors associated with poor
adherence included racial/ethnic minority, age less than 35 years, and
indications of moderate or severe depression.
The questionnaire was not completed systematically in the
clinic, which may limit generalizability, and self-reported measures may have
introduced social desirability bias.
Patients were willing to disclose mental health distress,
substance use, and suboptimal medication adherence to providers, which
highlights the importance of routinely assessing these behaviors during clinic
visits. Our findings suggest that treating depression may be an effective
strategy to improve adherence to HIV medications.
Full article at: http://goo.gl/1ECY7h
By:
- 1doctoral student, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
- 2assistant research professor, Duke Global Health Institute, Duke University, Durham, North Carolina.
- 3research assistant, Duke Global Health Institute, Duke University, Durham, North Carolina.
- 4assistant research professor, Duke Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, North Carolina.
- 5associate professor of medicine, Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina.
- 6professor, Department of Psychology and Neuroscience, Duke University; professor, Global Health Institute, Duke University; director, social and behavioral sciences, Duke Center for AIDS Research, Duke University; director of clinical psychology, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina kathleen.sikkema@duke.edu.
More at: https://twitter.com/hiv_insight
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