HIV management and Mental health

                 Welcome back! Now that you know the basics for HIV, I thought it would be interesting to look at some relatively recent literature. The article “Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic”, explores the effect of mental health and its relationship between HIV positive peoples’s adherence to HIV antiretroviral(ARV) therapy.One of the rationales behind this study stems from the fact that depression and substance abuse is more prevalent in HIV positive people than the regular population. Additionally, previous literature has shown that there are reasons to believe mental health and substance abuse problems are related to the decline in adherence to the HIV medicine.

                 To investigate this interaction between mental health and HIV adherence, HIV patients in North Carolina clinics were sampled. A clinic in North Carolina was chosen to represent the southern United States, since there are disproportionately higher rates of HIV in the south. The study’s participants were administered questionaries that assessed their depression levels (past and present), prior psychiatric disorder diagnosis, drug/alcohol usage, smoking and adherence. They found that 12.2% of patients had moderate to severe depression, 38.6% had a previous psychiatric diagnosis, 8.2% of people reported “problematic” drug use. They discovered that these realms are related and that about 22% of people had below “ideal” acceptable levels of HIV drug adherence. An additional/more detailed table of the results is provided below.

                 The results from this study found that there is a “suboptimal adherence to ARV medication” in racial/ethnic minorities, females, young people and those who have moderate/severe depression. It is important to note that the nature of this study does not indicate causation because they were not allowed to manipulate people into certain groups. However,  this correlation provides relevant information for health care professionals and a basis for further research. In order to increase adherence to the ARV health care professionals should analyze  possible levels of depression and give them tools to cope with it so that they can lead an overall healthier life style. Moving forward, there should be more studies conducted on all of these different variables individually(i.e psychiatric disorders and HIV) with respect to HIV adherence. Additionally, the correlation needs to be retested to prove the reliability of results. 

                                                                 Reference 

Sikkema , K. J. , Watt , M. H. , Drabkin , A. S. , Meade , C. S. , Hansen , N. B. , & Pence , B. W. ( 2010 ). Mental health treatment to reduce HIV transmission risk behavior: A positive prevention model . AIDS and Behavior , 14 , 252 – 262