Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic.
Abstract
BACKGROUND: The HIV/AIDS epidemic is a significant public health concern in North
Carolina, and previous research has pointed to elevated mental health distress and
substance use among HIV-infected populations, which may impact patients' adherence
to medications. The aims of this study were to describe the prevalence of mental health
and substance use issues among patients of a North Carolina HIV clinic, to examine
differences by demographic characteristics, and to examine factors associated with
suboptimal adherence to HIV medications. METHODS: This study was a secondary analysis
of clinical data routinely collected through a health behavior questionnaire at a
large HIV clinic in North Carolina. We analyzed data collected from February 2011
to August 2012. RESULTS: The sample included 1,398 patients. Overall, 12.2% of patients
endorsed current symptomology indicative of moderate or severe levels of depression,
and 38.6% reported receiving a psychiatric diagnosis at some point in their life.
Additionally, 19.1% had indications of current problematic drinking, and 8.2% reported
problematic drug use. Nearly one-quarter (22.1%) reported suboptimal adherence to
HIV medications. Factors associated with poor adherence included racial/ethnic minority,
age less than 35 years, and indications of moderate or severe depression. LIMITATIONS:
The questionnaire was not completed systematically in the clinic, which may limit
generalizability, and self-reported measures may have introduced social desirability
bias. CONCLUSION: Patients were willing to disclose mental health distress, substance
use, and suboptimal medication adherence to providers, which highlights the importance
of routinely assessing these behaviors during clinic visits. Our findings suggest
that treating depression may be an effective strategy to improve adherence to HIV
medications.
Type
Journal articleSubject
AdolescentAdult
Anti-HIV Agents
Depression
Female
HIV Infections
Humans
Male
Medication Adherence
Mental Disorders
Mental Health
Middle Aged
North Carolina
Prevalence
Substance-Related Disorders
Surveys and Questionnaires
Young Adult
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https://hdl.handle.net/10161/10742Published Version (Please cite this version)
10.18043/ncm.76.3.148Publication Info
Sikkema, KJ (2015). Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic. N C Med J, 76(3). pp. 148-155. 10.18043/ncm.76.3.148. Retrieved from https://hdl.handle.net/10161/10742.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Kathleen J. Sikkema
Research Professor in the Department of Psychology and Neuroscience
Kathleen J. Sikkema, Ph.D., Gosnell Family Professor of Global Health, Psychology
and Neuroscience, and Psychiatry and Behavioral Sciences at Duke University, is a
clinical psychologist with emphases in health and community psychology. She is the
Director of Doctoral Studies at the Duke Global Health Institute (DGHI), Director
of the Social and Behavioral Science Core in Duke's Center for AIDS Research (CFAR),
an

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