Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic.
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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.
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Published Version (Please cite this version)10.18043/ncm.76.3.148
Publication InfoSkalski, Linda M; Watt, Melissa H; MacFarlane, Jessica C; Proeschold-Bell, Rae Jean; Stout, Jason E; & Sikkema, Kathleen J (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.
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Associate Research Professor of Global Health
Rae Jean Proeschold-Bell is interested in the interplay between mental and physical well-being and has designed and tested interventions that integrate care for people with obesity and depression; HIV/AIDS and substance use; and hepatitis C and alcohol use. Most recently, Rae Jean has been studying positive mental health as a way to prevent depression and promote caring for one's physical health. Her work currently focuses on caregivers, including clergy in North Carolina and ca
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
Professor of Medicine
My research focuses on the epidemiology, natural history, and treatment of tuberculosis and nontuberculous mycobacterial infections. I am also interested in the impact of HIV infection on mycobacterial infection and disease, and in examining health disparities as they relate to infectious diseases, particularly in immigrant populations.
Adjunct Associate Professor of Global Health
Dr. Watt's research focuses on understanding and addressing gender-specific health issues in sub-Saharan Africa, with specific attention to HIV, substance use and mental health. In Tanzania, she currently leads an implementation science study aimed at improving access to long-term antiretroviral therapy for pregnant women with HIV. In South Africa, she is collaborating with Dr. Kathleen Sikkema on a study to support H
Alphabetical list of authors with Scholars@Duke profiles.