182510 HIV risk behaviors among medical patients with co-occurring substance use disorders and severe mental illness

Wednesday, October 29, 2008

Arielle Morganstern, BA , Psychiatry, University of California San Francisco, San Francisco, CA
Carmen Masson, PhD , Psychiatry, University of California San Francisco, San Francisco, CA
Karl Sporer, MD , Emergency Services, University of California San Francisco, San Francisco, CA
Background: Little is known about HIV risk behaviors of medical patients with co-occurring substance use disorders (SUDs) and severe mental illness (SMI), yet the rate of HIV is especially high among this group. Methods: Participants were 16 medical patients (women = 5; men = 11) recruited from medical units of a public hospital, each of whom took part in a brief interview to screen for psychiatric symptoms and HIV related risk behaviors. Results: Mean age was 45 (SD = 9.0) and most were homeless (n = 9) and predominantly of ethnic minority (n = 7) and mixed race/ethnicity (n = 4). DSM-IV psychiatric diagnoses included mood disorder (n = 11), posttraumatic stress disorder (n = 3), and psychotic disorder (n = 2). Women had a mean of 5.4 (range = 1-20) sexual partners in the past 30 days and men had 0.9 (range = 0-2). Men and women rarely used condoms for vaginal sex and never used condoms for anal sex. Seven participants were injection drug users and the most frequent injection drug use risk behavior was splitting the drug solution with another injector. Conclusions: It is feasible to screen for SUDs and SMI in a public hospital setting. This sample engaged in high levels of HIV related sexual and drug use behaviors. More resources should be directed toward identifying medical patients with co-occurring SUDs and SMI who are at high risk for HIV.

Learning Objectives:
1. Audience members will learn to assess psychiatric symptoms in substance users seeking care in public hospital settings. 2. Audience members will be able to describe HIV risk behaviors among medical patients with co-occurring substance use disorders and severe mental illness. 3. Audience members will be able to develop a plan to prevent HIV/AIDS among persons with substance use disorders and severe mental illness.

Keywords: HIV Risk Behavior, Public Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am involved in collecting and analyzing the data and interpreting the study findings. I have also obtained training in the screening, recruitment, and administration of the research tools.
Any relevant financial relationships? No

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.

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