Rationale: Growing numbers of PSMD have acquired HIV. Most HIV interventions for PSMD emphasize prevention and offer little to help already-infected PSMD cope with challenging ART regimens. While ART has improved health outcomes, many clinicians are reluctant to prescribe ART to PSMD.
Methods: Individual and group interviews were conducted with 14 HIV+ PSMD who are patients of the Psychiatry Department and/or the Infectious Diseases Clinic in a New York City hospital. Topics included experiences with psychiatric and ART regimens separately, co-management of regimens, services received from the two departments, service needs, and personal concerns such as privacy and stigma.
Results: Respondents were greatly affected by the stigmatization of the two conditions. Many openly acknowledged one while refusing to disclose the other. Similarly, most respondents received services from either Psychiatry or Infectious Diseases and avoided association with the other. Privacy concerns inhibited service coordination between the two departments. Other barriers were caused by respondents seeking services outside the hospital, without informing the doctor. Because of concerns about side effects, drug interactions, and toxicity, some delayed seeking treatment. Co-management of the two regimens was assisted by the use of alarms and pill boxes, and through support from family members or workers.
Conclusion: PSMD with HIV disease need special supports to cope with the demands of these difficult regimens. Efforts should be given to developing and testing innovative models to help PSMD cope with both HIV disease and their psychiatric illness and to assist them in adherence with treatments for both conditions.
Learning Objectives: To describe the difficulties faced by HIV-infected persons with severe mental disorders
Keywords: HIV/AIDS, Adherence
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Harlem Hospital
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment, grants