228906 Duration of AIDS and Its Influence on Service Use for Serious Mental Illness, Anxiety and Sexual Disorders

Tuesday, November 9, 2010 : 1:15 PM - 1:30 PM

William Mkanta, PhD , Public Health, Western Kentucky University, Bowling Green, KY
Grace Lartey, PhD , Department of Public Health, Western Kentucky University, Bowling Green, KY
Maria Mejia, MD , Research Service, Malcom Randall VAMC NF/SG Veterans Health System, Gainesville, FL
Tina Abrefa-Gyan, MSW , Social Work, University of Maryland, Baltimore, Baltimore, MD
Shalini Singh , Public Health, Western Kentucky University, Bowling Green, KY
Huma Ansari , Public Health, Western Kentiucky University, Bowling Green, KY
R. Paul Duncan, PhD, MS , Department of Health Services Research, Management, & Policy, University of Florida, Gainesville, FL
Objectives: While mental health has been a major concern among HIV-infected individuals, it is not clearly known to what extent length of survival after an AIDS diagnosis influences service use for mental disorders. Length of survival after AIDS was investigated with its influence on outpatient services for serious mental illness as well as anxiety and sexual disorders. Methods: Study involved male veterans. We identified mental health disorders using the International Classification of Diseases, and applied negative binomial regression to predict the number of outpatient visits associated with the disorders. Incident rate ratios (IRR) generated by the binomial regression were used to assess relative change in the number of visits. Results: Overall, 36% of the total 3,597 participants had outpatient mental health visits in 2003. White patients were more likely to have an outpatient encounter. Duration of AIDS had no impact on service use for serious mental illness; however, it had a significant positive association with the number of visits for anxiety and sexual disorders (IRR=1.87; 95% CI=1.25-2.77). Having lower CD4 cell count and mortality were associated with increased service use for anxiety and sexual disorders; while being an injection drug user, being a man who have sex with men and having AIDS-defining illness were predictors of visits for serious mental illness. Conclusion: Duration of AIDS may pose additional challenges in HIV care due to mental health service needs. Continual assessment of mental health status as patients attain longer lives with AIDS is necessary to ensure optimal use of the services.

Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
Demonstrates that duration of AIDS may pose challenges in HIV care due to increased prevalence of mental disorders. Differentiate the role of different groups of mental health disorders in the rate of service utilization.

Keywords: HIV/AIDS, Mental Health Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was PI of the project and was officially awarded access to the data and was completely involved in conducting the study.
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.