|dc.description.abstract||Background: There have been no previous nationally representative estimates of the prevalence of mental disorders and drug use among adults receiving care for human immunodeficiency virus (HIV) disease in the United States. It is also not known which clinical and sociodemographic factors are associated with these disorders.
Subjects and Methods: We enrolled a nationally representative probability sample of 2864 adults receiving care for HIV in the United States in 1996. Participants were administered a brief structured psychiatric instrument that screened for psychiatric disorders (major depression, dysthymia, generalized anxiety disorders, and panic attacks) and drug use during the previous 12 months. Sociodemographic and clinical factors associated with screening positive for any psychiatric disorder and drug dependence were examined in multivariate logistic regression analyses.
Results: Nearly half of the sample screened positive for a psychiatric disorder, nearly 40% reported using an illicit drug other than marijuana, and more than 12% screened positive for drug dependence during the previous 12 months. Factors independently associated with screening positive for a psychiatric disorder included number of HIV-related symptoms, illicit drug use, drug dependence, heavy alcohol use, and being unemployed or disabled. Factors independently associated with screening positive for drug dependence included having many HIV-related symptoms, being younger, being heterosexual, having frequent heavy alcohol use, and screening positive for a psychiatric disorder.
Conclusions: Many people infected with HIV may also have psychiatric and/or drug dependence disorders. Clinicians may need to actively identify those at risk and work with policymakers to ensure the availability of appropriate care for these treatable disorders.||
|dc.description.sponsorship||The HCSUS is being conducted under cooperative agreement U-01HS08578 between RAND and the Agency for Healthcare Research and Quality (formerly Agency for Health Care Policy and Research) (Dr Shapiro, principal investigator; Dr Bozzette, co–principal investigator). Substantial additional funding for this cooperative agreement was provided by the Health Services Resources Administration, Rockville, Md; the National Institute of Mental Health; the National Institute on Drug Abuse, Bethesda, Md; and the National Institutes of Health (NIH) Office of Research on Minority Health through the National Institute for Dental Research, Bethesda, Md. Additional support for this project was provided by the Robert Wood Johnson Foundation, Princeton, NJ; Merck and Company, Whitehouse Station, NJ; Glaxo-Wellcome, Incorporated, Research Triangle Park, NC; the National Institute on Aging, Bethesda; and the Office of the Assistant Secretary for Planning and Evaluation in the US Department of Health and Human Services, Washington, DC. Dr Bing received support for this study from the National Institute of Mental Health as a University of California, Los Angeles Faculty Scholar in Mental Health Services Research (grant MH00990), the California Universitywide AIDS Research Program, Oakland, and the NIH Center on Minority Health and Health Disparities through the National Institute on Alcohol Abuse and Alcoholism, Bethesda (grant AA11899).||