Association of an integrated behavioral treatment program with improvement of health outcomes among individuals with HIV, mental illness, and substance use disorders in the southeast

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.