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Abstract #157516

Susan S. Reif, PhD, MSW, Center for Health Policy, Duke University, 1509 Biltmore dr, Charlotte, NC 28207, 704 376-3350, susan_reif@yahoo.com and Kathryn Whetten, MPH, PhD, Center of Health Policy, Duke University, 302 Towerview Rd, Durham, NC 27708.

Background: Effective behavioral treatment interventions are needed to address mental health and substance use disorders among HIV-infected individuals, as these disorders are associated with inferior health outcomes such as poorer treatment adherence and continued HIV risk behavior. This study examines changes in clinical and psychiatric status observed among participants in a treatment program for HIV-infected individuals with both substance use and mental disorders. Methods: Study participants (n=141) were recruited through routine mental health and substance abuse screening at Infectious Disease clinics in the Southeast between 2000 and 2002. Participants received mental health and substance abuse treatment for one year and were interviewed at three month intervals. The treatment intervention was tailored to the individual's stage of readiness for behavior change and addressed a continuum of client needs that may influence treatment outcomes The model also included strong collaboration between medical and behavioral healthcare professionals Results: Using linear regression analysis, we detected statistically significant decreases in participants' psychiatric symptomatology, illicit substance use, alcohol use, and inpatient hospital days from baseline to the 6 and 12 month interviews. Participants also reported fewer emergency room visits and were more likely to be receiving antiretroviral medications and adequate psychotropic medication regimens at follow-up. No changes in sexual risk, physical health, or medical adherence were detected after treatment participation. Conclusions: This integrated treatment model offers an option for treating HIV-infected individuals with mental health and substance use disorders that can be adapted for use in a variety of psychiatric and medical treatment settings.

Learning Objectives:

• To recognize the level of mental illness and substance abuse among HIV-infected individuals and identify the negative outcomes associated with these comorbidities.
• To describe the components of a behavioral health intervention that has been successful in improving outcomes for individuals triply diagnosed with HIV, mental disorder, and substance use disorder.
• To determine how the behavioral health treatment strategies used in the treatment intervention can be adapted for use in a variety of HIV care and prevention settings.

Keywords: Mental Health, Substance Abuse Treatment

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.