Health Outcomes of HIV-Infected People with Mental Illness

Yehia, Baligh R.; Stephens-Shield, Alisa J.; Momplaisir, Florence; Taylor, Lynne; Gross, Robert; Dubé, B; Glanz, Karen; Brady, Kathleen A.

doi:10.1007/s10461-015-1080-4

Cited by 45 publications

(31 citation statements)

References 37 publications

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“…Neither alcohol nor NIDU was statistically associated with retention in care in our primary analysis, as found in another study [ 38 ]. However, when the number of drinks was included in the analysis (instead of any alcohol use), a larger number of drinks increased the chance of not being retained in care.…”

Section: Discussionsupporting

confidence: 67%

Is substance use associated with HIV cascade outcomes in Latin America?

et al. 2018

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BackgroundThe HIV care cascade has improved in Latin America over the last decade. However, the influence of alcohol and noninjected drug use (NIDU) on cascade outcomes is mostly unknown. This study estimated the association of alcohol and NIDU with retention in care, loss to follow up (LTFU), and virologic failure (VF).MethodsIndividuals ≥18 years attending routine HIV clinic visits and completing the Rapid Screening Tool (RST; evaluating NIDU and ART adherence in 7-day recall period) during 2012–13 were followed up to 2015 in the Caribbean, Central and South America network for HIV epidemiology. Adjusted odds ratios (aOR) were calculated for the association of alcohol consumption and NIDU with retention in care by logistic regression; adjusted hazard ratios (aHR) were estimated for the associations with LTFU and VF by Cox regression.ResultsAmong 3604 individuals, the proportions retained in care for one year were 84%, 79%, 72%, and 69% for patients reporting non-use, alcohol use, NIDU, and both alcohol and NIDU, respectively. For the same patient groups, the proportions LTFU over 18 months were 6%, 8%, 12%, and 13%, respectively. There were 1901 patients (53%) with HIV RNA results; VF proportions were similar between users and nonusers (ranging from 14–16%). After controlling for age, sex, study site, HIV transmission mode, time on ART, AIDS status, and CD4 count, neither alcohol use (aOR = 1.1, CI = 0.9–1.4; aHR = 1.0, CI = 0.8–1.3) nor NIDU (aOR = 1.3, CI = 0.9–1.8; aHR = 1.4, CI = 0.9–2.1) were significantly associated with retention or VF, respectively. However, both alcohol use (aHR = 1.2, CI = 1.02–1.4) and NIDU (aHR = 1.3, CI = 1.00–1.8) were associated with increased LTFU.ConclusionAlcohol use and NIDU in a 7-day recall period increased the risk of being LTFU during the next 18 months, highlighting the need for routine screening and targeted interventions to keep these individuals in care and on ART.

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Section: Discussionsupporting

confidence: 67%

Is substance use associated with HIV cascade outcomes in Latin America?

et al. 2018

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“…Participants who had achieved DVS were less likely to report severe depression compared with those who had achieved SVS. Previous studies have shown poor HIV outcomes among persons with a mental health condition (45,46). Even with the support of the patientcentered interventions, 80% of CJI Black male participants had not achieved DVS which may point to the need for more integrated and/or structural-focused strategies to support medication adherence and DVS among this sample of participants (47,48).…”

Section: Changes In Viral Suppression and Correlates Of Dvsmentioning

confidence: 73%

Correlates of Durable Viral Suppression (DVS) Among Criminal Justice-involved (CJI) Black Men Living with HIV in Louisiana

et al. 2019

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Durable viral suppression (DVS) is needed to reduce HIV transmission risk and prevent new HIV infections. We examined changes in viral suppression and correlates of DVS among 97 criminal justice-involved (CJI) Black men living with HIV in Louisiana enrolled in a linkage, reengagement, and retention in care intervention. Most participants (75%) were Black men who have sex with men. Forty-four percent (44%) were virally suppressed at baseline and only 20% had achieved DVS over a 12-month period. Multinomial logistic regression analyses showed that compared with DVS participants, those with no viral suppression (NVS) and some viral suppression (SVS) were more likely to have lived with HIV for a longer period of time and were less likely to be adherent at baseline. Medication adherence was critical for DVS among this sample of CJI Black men living with HIV who represent a high priority population for HIV care and treatment interventions.

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“…PLWH with a history of injection drug use were reported to be less likely to access ART in several studies 24,25 . Another study in Philadelphia observed that PLWH who had mental illness were less likely to achieve viral suppression than PLWH without mental illness (adjusted OR 0.65, 95 % CI 0.47-0.91) 26 . These findings indicate that more outreach and/or services are needed to help those with mental health and substance use disorders.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal study assessing differences in causes of death among housed and homeless people diagnosed with HIV in San Francisco

Hessol

Eng

et al. 2019

Preprint

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Background San Francisco (SF) has implemented several programs addressing the needs of two large vulnerable populations: people living with HIV and those who are homeless. Assessment of these programs on health outcomes is paramount for reducing preventable deaths. Methods Individuals diagnosed with HIV/AIDS and reported to the SF Department of Public Health HIV surveillance registry, ages 13 years or older, who resided in SF at the time of diagnosis, and who died between January 1, 2002, and December 31, 2016 were included in this longitudinal study. The primary independent variable was housing status, dichotomized as ever homeless since diagnosed with HIV, and the dependent variables were disease-specific causes of death, as noted on the death certificate. The Cochran-Armitage test measured changes in the mortality rates over time and unadjusted and adjusted Poisson regression models measured prevalence ratios (PR) and 95% confidence intervals (CI) for causes of death. Results A total of 4158 deceased individuals were included in the analyses: the majority were male (87%), ages 40-59 years old at the time of death (64%), non-Hispanic White (60%), men who have sex with men (54%), had an AIDS diagnosis prior to death (87%), and San Francisco residents at the time of death (63%). Compared to those who were housed, those who were homeless were more likely to be younger at time of death, African American, have a history of injecting drugs, female or transgender, and were living below the poverty level (all p values < 0.0001). Among decedents who were SF residents at the time of death, there were declines in the proportion of deaths due to AIDS-defining conditions (p < 0.05) and increases in accidents, cardiomyopathy, heart disease, ischemic disease, non-AIDS cancers, and drug overdoses (p < 0.05). After adjustment, deaths due to mental disorders (PR=1.61, 95% CI 1.23, 2.12) were more likely and deaths due to non-AIDS cancers (PR=0.63, 95% CI 0.44, 0.88) were less likely among those experiencing homelessness. Conclusions Additional efforts are needed to improve mental health services to homeless people with HIV and prevent mental-health related mortality.

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Health Outcomes of HIV-Infected People with Mental Illness

Cited by 45 publications

References 37 publications

Is substance use associated with HIV cascade outcomes in Latin America?

Is substance use associated with HIV cascade outcomes in Latin America?

Correlates of Durable Viral Suppression (DVS) Among Criminal Justice-involved (CJI) Black Men Living with HIV in Louisiana

A longitudinal study assessing differences in causes of death among housed and homeless people diagnosed with HIV in San Francisco

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