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. 2011 May 15;25(8):1113-8.
doi: 10.1097/QAD.0b013e3283463f09.

Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons

Adam W Carrico  1 , David R Bangsberg, Sheri D Weiser, Maggie Chartier, Samantha E Dilworth, Elise D Riley
Affiliations

Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons

Adam W Carrico et al. AIDS. .

Abstract

Objective: Research on the role psychiatric factors in HIV disease management has yielded discrepant findings, possibly because prior studies did not include comprehensive psychiatric screeners. This study administered a validated screener to examine psychiatric correlates of highly active antiretroviral therapy (HAART) utilization and viral load.

Design: Community-recruited, HIV-positive impoverished persons provided sociodemographic information, completed a Diagnostic Interview Schedule that screened for psychiatric disorders, and provided a blood sample to measure HIV disease markers.

Methods: In this cross-sectional investigation with 227 participants, a multiple logistic regression model examined correlates of HAART utilization compared to a reference group that was eligible for (i.e. CD4(+) cell count <350 cells/μl) but not taking HAART. A multiple linear regression model examined correlates of HIV viral load among 147 participants on HAART.

Results: Sleeping on the street [adjusted OR (AOR) = 0.06; 95% confidence interval (CI) = 0.01–0.26] and screening positive for a stimulant use disorder (AOR = 0.29; 95% CI = 0.13–0.65) were independently associated with lower odds of HAART utilization. Conversely, enrollment in the AIDS Drug Assistance Program (AOR = 3.94; 95% CI = 1.45–10.73) and receipt of mental health treatment (AOR = 4.78; 95% CI = 1.77–12.87) were independently associated with increased odds of HAART utilization. Among those on HAART, screening positive for a severe mental illness was independently associated with a six-fold higher viral load.

Conclusion: Providing psychiatric treatment could optimize health outcomes among HIV-positive impoverished persons and boost the effectiveness of 'test and treat' approaches to HIV prevention.

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References

    1. Palella FJ, Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998;338:853–860. - PubMed
    1. Karon JM, Fleming PL, Steketee RW, De Cock KM. HIV in the United States at the turn of the century: an epidemic in transition. Am J Public Health. 2001;91:1060–1068. - PMC - PubMed
    1. Poundstone KE, Chaisson RE, Moore RD. Differences in HIV disease progression by injection drug use and by sex in the era of highly active antiretroviral therapy. Aids. 2001;15:1115–1123. - PubMed
    1. Arnold M, Hsu L, Pipkin S, McFarland W, Rutherford GW. Race, place and AIDS: the role of socioeconomic context on racial disparities in treatment and survival in San Francisco. Soc Sci Med. 2009;69:121–128. - PMC - PubMed
    1. Carrico AW. Substance use and HIV disease progression in the HAART era: Implications for the primary prevention of HIV infection. Life Sci. doi: 10.1016/j.lfs.2010.10.002. in press. - DOI - PubMed

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