Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Kelly, Jeffrey A.; Murphy, Debra A.; Bahr, G. Richard; Koob, Jeffrey J.; Morgan, M G; Kalichman, Seth C.; Stevenson, Lois; Brasfield, Ted L.; Bernstein, Bobbi; Lawrence, Janet S. St.

doi:10.1037//0278-6133.12.3.215

Cited by 89 publications

(1 citation statement)

References 14 publications

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“…12 Several mental health diagnoses are linked to HIV progression through poor medication adherence 13 , 14 and risky behaviors. 13 , 15 After controlling for adherence and clinical and demographic characteristics, depression is linked to a decline in CD4 count 16 – 18 and increased viral load and mortality. 16 , 18 – 21 Mental illnesses are often underreported, but national estimates indicate that up to half of PLWH may be affected.…”

Section: Introductionmentioning

confidence: 99%

HIV Care Continuum Among People Living With HIV and History of Arrest and Mental Health Diagnosis

Wiehe,

Nelson,

Aalsma

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective: Justice involvement and psychiatric comorbidities contribute to excess HIV morbidity, yet their interaction is poorly understood. We examined associations of this overlap with HIV outcomes among people living with HIV (PLWH). Methods: We conducted a retrospective cohort study of PLWH aged 13 years and older residing in Marion County (Indianapolis), IN, during 2018 (n = 5730) using linked HIV surveillance, arrest, and clinical data. We used univariable and multivariable regression to evaluate main and interaction effects of 2010–2017 arrest and mental health diagnosis on 2018 linkage to care (LTC), retention in care (RIC), and undetectable viral load (UVL). Results: LTC decreased among those with, versus without, an arrest (P = 0.02), although mental health diagnoses had no significant effect on LTC. When controlling for demographics and substance use disorder, analyses indicated a protective effect of arrest history on odds of RIC (adjusted odds ratio [aOR] = 1.54) and UVL (aOR = 1.26). Mental health diagnosis also increased odds of RIC (aOR = 2.02) and UVL (aOR = 1.95). Post hoc tests demonstrated that these results were mediated by outpatient care utilization, although an arrest or mental health diagnosis did increase odds of RIC among PLWH and a history of low outpatient utilization. Conclusions: Outpatient care utilization improves HIV outcomes, even among those with justice involvement and psychiatric comorbidities. Holistic approaches to care can increase utilization. Implementation of “no wrong door” approaches, such as integration of mental health care in the primary care setting, simplifies health care navigation and improves access. Among those arrested, access to a Behavioral Court program can improve, rather than disrupt, HIV care.

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Section: Introductionmentioning

confidence: 99%

HIV Care Continuum Among People Living With HIV and History of Arrest and Mental Health Diagnosis

Wiehe,

Nelson,

Aalsma

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Depressive Affect and Survival Among Gay and Bisexual Men Infected With HIV

Mayne¹

1996

Arch Intern Med

153

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Psychosocial Characteristics Associated with Both Antiretroviral Therapy Adherence and Risk Behaviors in Women Living with HIV

et al. 2015

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The purpose of this study was to identify key psychosocial characteristics of HIV-infected women who exhibit different levels of both ART adherence and risk behaviors. We analyzed baseline data from 193 predominately African American HIV-infected women participating in a behavioral clinical trial. Women were categorized into high/low groups based on levels of adherence and risky behaviors. There was a significant interaction effect for internal motivation for adherence. Women at high risk for poor health and transmitting HIV (low adherence/high risk group) had the lowest levels of internal motivation and also reported more difficult life circumstances. Gender roles, caretaking and reliance on men for economic and other support may promote external versus internal motivation as well as riskier behaviors in this group. The highest levels of internal motivation were found in those with High Adherence/High Risk behaviors. This group was highly knowledgeable about HIV and had the lowest VL. Compared to others, this group seems to tolerate risky behaviors given their high level of adherence. Adherence and risk reduction behaviors are key to individual and public health. Motivation and risk compensation should be addressed when providing interventions to women living with HIV.

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Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Cited by 89 publications

References 14 publications

HIV Care Continuum Among People Living With HIV and History of Arrest and Mental Health Diagnosis

HIV Care Continuum Among People Living With HIV and History of Arrest and Mental Health Diagnosis

Depressive Affect and Survival Among Gay and Bisexual Men Infected With HIV

Psychosocial Characteristics Associated with Both Antiretroviral Therapy Adherence and Risk Behaviors in Women Living with HIV

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