TY - JOUR
T1 - Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study
AU - Himelhoch, Seth
AU - Josephs, Joshua S.
AU - Chander, Geetanjali
AU - Korthuis, P. Todd
AU - Gebo, Kelly A.
N1 - Funding Information:
Sponsorship: Supported by the National Institutes of Drug Abuse: Dr. Himelhoch (K23- DA019820) and Dr. Korthuis (K23-DA019809). Dr. Gebo is supported by the Agency for Healthcare Research and Quality (290-01-012) and Aging (R01 AG026250). Dr. Gebo also received support from the Johns Hopkins University Richard S. Ross Clinician Scientist Award.
PY - 2009/11
Y1 - 2009/11
N2 - Objective: Although co-occurring psychiatric disorders are highly prevalent among those with HIV, little is known about the use of outpatient mental health services (MHS) and psychotropic medication in the highly active antiretroviral therapy (HAART) era. Methods: During 2003, 951 patients were interviewed at 14 sites in the HIV Research Network. Patients were questioned about use of MHS and psychotropic medications. Logistic regression was used to identify socio-demographic and clinical factors associated with MHS and psychotropic medication utilization. Results: The sample characteristics were as follows: 68% male, 52% black, 14% Hispanic, median age 46 years (range 20-85), 69% were on HAART. Approximately 34% reported at least one MHS within 6 months and 37% reported use of psychotropic medication for a mental health condition. In multivariate logistic regression, MHS was greater among disabled patients [adjusted odds ratio 2.39 (95% CI 1.53-3.72)], current [2.26 (1.53-3.35)] and former drug users [1.84 (1.24-2.73)], and those with more than seven primary care visits in the past 6 months. Blacks [0.61 (0.41-0.92)] were significantly less likely to use MHS compared to whites. Similarly, usage of psychotropic medications was greater among disabled patients [1.79 (1.14-2.82)], women [1.66 (1.13-2.43)], )] and those with more than seven primary care visits. Blacks [0.37 (0.24-0.58])] and Hispanics [0.39 (0.22-0.72)] were less likely to use a psychotropic medication. HAART utilization was not associated with MHS or psychiatric medication use. Conclusions: In the HAART era, self-reported rates of mental health service and psychotropic medication utilization are high. Blacks continue to report lower use of MHS and psychotropic medication compared to whites.
AB - Objective: Although co-occurring psychiatric disorders are highly prevalent among those with HIV, little is known about the use of outpatient mental health services (MHS) and psychotropic medication in the highly active antiretroviral therapy (HAART) era. Methods: During 2003, 951 patients were interviewed at 14 sites in the HIV Research Network. Patients were questioned about use of MHS and psychotropic medications. Logistic regression was used to identify socio-demographic and clinical factors associated with MHS and psychotropic medication utilization. Results: The sample characteristics were as follows: 68% male, 52% black, 14% Hispanic, median age 46 years (range 20-85), 69% were on HAART. Approximately 34% reported at least one MHS within 6 months and 37% reported use of psychotropic medication for a mental health condition. In multivariate logistic regression, MHS was greater among disabled patients [adjusted odds ratio 2.39 (95% CI 1.53-3.72)], current [2.26 (1.53-3.35)] and former drug users [1.84 (1.24-2.73)], and those with more than seven primary care visits in the past 6 months. Blacks [0.61 (0.41-0.92)] were significantly less likely to use MHS compared to whites. Similarly, usage of psychotropic medications was greater among disabled patients [1.79 (1.14-2.82)], women [1.66 (1.13-2.43)], )] and those with more than seven primary care visits. Blacks [0.37 (0.24-0.58])] and Hispanics [0.39 (0.22-0.72)] were less likely to use a psychotropic medication. HAART utilization was not associated with MHS or psychiatric medication use. Conclusions: In the HAART era, self-reported rates of mental health service and psychotropic medication utilization are high. Blacks continue to report lower use of MHS and psychotropic medication compared to whites.
KW - HIV-infected patients
KW - Outpatient mental health services
KW - Psychotropic medications
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U2 - 10.1016/j.genhosppsych.2009.05.009
DO - 10.1016/j.genhosppsych.2009.05.009
M3 - Article
C2 - 19892212
AN - SCOPUS:70350568925
SN - 0163-8343
VL - 31
SP - 538
EP - 545
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 6
ER -