TY - JOUR
T1 - Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons.
AU - Carrico, Adam W.
AU - Bangsberg, David R.
AU - Weiser, Sheri D.
AU - Chartier, Maggie
AU - Dilworth, Samantha E.
AU - Riley, Elise D.
PY - 2011/5/15
Y1 - 2011/5/15
N2 - 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. 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. 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. 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. Providing psychiatric treatment could optimize health outcomes among HIV-positive impoverished persons and boost the effectiveness of 'test and treat' approaches to HIV prevention.
AB - 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. 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. 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. 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. 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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U2 - 10.1097/qad.0b013e3283463f09
DO - 10.1097/qad.0b013e3283463f09
M3 - Article
C2 - 21399478
AN - SCOPUS:85027919776
SN - 0269-9370
VL - 25
SP - 1113
EP - 1118
JO - AIDS (London, England)
JF - AIDS (London, England)
IS - 8
ER -