Medical Outcomes of HIV-Infected Individuals Two Years After Initiating Specialized Psychiatric Treatment Services

Abstract

HIV-infected individuals experience high rates of mental health difficulties. This study examines archival chart data of HIV-infected individuals (N = 94; 54% African American) 2 years after initiating specialized psychiatric services (psychotherapy, pharmacotherapy, or both) to (a) characterize demographic correlates of medical outcomes; (b) describe factors associated with continued psychiatric care at 2 years; and (c) compare medical outcomes for those who continued in psychiatric care and those who did not. Results indicated that there was higher emergency department use and medical hospitalizations among women, ethnic minorities, and heterosexual patients over 2 years. Physicians reported greater adherence problems among minority patients and unemployed individuals. Patients with a history of sexual or physical abuse and individuals with psychotic disorder diagnoses were more likely to remain in psychiatric treatment. Current psychotropic medication use was associated with (a) fewer comorbid health conditions; (b) use of more medications; (c) greater use of HIV medications; (d) fewer physician concerns about medication adherence; (e) lower frequency of an AIDS diagnosis; and (f) less frequent occurrence of a detectable viral load. While there were few differences between those who remained in specialized care and those who did not, patients who continued in treatment had fewer comorbid health conditions at 2 years. In summary, findings suggest differential health outcomes based on demographic characteristics and psychotropic medication use with few differences associated with continued specialized psychiatric care. Future research should seek to further examine mechanisms associated with the impact of ongoing psychiatric care on longitudinal medical outcomes among HIV-infected individuals.

KEYWORDS:

• HIV
• medical outcomes
• mental health
• psychiatric illness

Acknowledgments

Jennifer L. Brown was supported by Grant K12 GM000680 from the National Institute of General Medical Sciences.

Notes

Note. Pearson's correlation coefficient was used to assess the association between age and medical outcomes. All other analyses utilized independent samples t-tests to assess differences in medical outcomes by demographic characteristic.

Note. Independent samples t-test was used to assess the association between age and medical outcomes. All other analyses utilized χ² tests to assess differences in medical outcomes by demographic characteristic.

Note. Frequencies (corresponding percentage) are presented for categorical outcomes. Means (standard deviations) are presented for continuous variables. Independent samples t-tests were used to assess differences between continuous variables. χ² analyses were used to assess differences in categorical outcomes.

Note. Means (standard deviations) are presented for continuous variables. Frequencies (corresponding percentage) are presented for dichotomous outcomes. Independent samples t-tests were used to assess differences between continuous variables. χ² analyses were used to assess differences in dichotomous outcomes.