Co-location of Health Care for Adults with Serious Mental Illness and HIV Infection

Department of Veterans Affairs, South Central Mental Illness Research, Education and Clinical Center (MIRECC), North Little Rock, AR 72114, USA.
Community Mental Health Journal (Impact Factor: 1.03). 09/2006; 42(4):345-61. DOI: 10.1007/s10597-006-9053-8
Source: PubMed

ABSTRACT This study describes persons with serious mental illness and comorbid HIV infection and examines the effect of co-location of mental health and HIV care on satisfaction, service utilization, and appropriateness of care. One hundred and eighteen subjects completed interviews and gave blood samples; medical records were abstracted. Most reported few barriers to care and satisfaction with mental health and HIV treatment. Co-location of mental health and HIV care did not influence satisfaction with care, utilization of services, or appropriateness of care. This report challenges the notion that persons with serious mental illnesses receive inadequate health care and that they have minimal capacity for illness management. These subjects may be benefiting from increased funding for, and attention to, persons with HIV infection.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aims of this study were to determine the association between service utilization and subjective cognitive complaints among adults with HIV and to identify the predictors of cognitive complaints as a step forward in improving service utilization in this population. Participants were 385 adults with HIV who were receiving care from AIDS service organizations (ASOs) in Alabama. Trained staff administered a face-to-face questionnaire, which assessed cognitive complaints and diverse aspects of service utilization. Significant correlations were found between cognitive complaints and work status, financial difficulties, difficulty getting medical care, legal problems, medication compliance, emotional problems, housing difficulties, counseling for sexual issues, transportation difficulties, and difficulty getting food. Multiple regression analysis identified the following predictors of cognitive complaints: level of education, physical pain, and stress. Given the association between cognitive complaints and service utilization, interventions aimed at reducing cognitive complaints and improving neuropsychological functioning may enhance service utilization and everyday functioning among adults with HIV.
    Journal of HIV/AIDS & Social Services 06/2008; 7(2):175-194. DOI:10.1080/15381500802006771
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: HIV-1 RNA and CD4 cell counts are important parameters for HIV care. The objective of this study was to assess the overall trends in HIV-1 viral load and CD4 cell counts within our clinic. Patients with at least one of each test performed by the Infectious Diseases Laboratory from 1999 through 2011 were included in this analysis. By adapting a novel statistical model, log(10) HIV-1 RNA means were estimated by month, and log(10)-transformed HIV-1 RNA means were estimated by calendar year. Geometric means were calculated for CD4 cell counts by month and calendar year. Log(10) HIV-1 RNA and CD4 cell count monthly means were also examined with polynomial regression. There were 1,814 individuals with approximately 25,000 paired tests over the 13-year observation period. Based on each patient's final value of the year, the percentage of patients with viral loads below the lower limit of quantitation rose from 29% in 1999 to 72% in 2011, while the percentage with CD4 counts <200 cells/µL fell from 31% to 11%. On average annually, the mean HIV-1 RNA decreased by 86 copies/mL and the mean CD4 counts increased by 16 cells/µL. For the monthly means, the correlations (R(2)) from second-order polynomial regressions were 0.944 for log(10) HIV-1 RNA and 0.840 for CD4 cell counts. Marked improvements in HIV-1 RNA suppression and CD4 cell counts were achieved in a large inner-city population from 1999 through 2011. This success demonstrates that sustained viral control with improved immunologic status can be a realistic goal for most individuals in clinical care.
    PLoS ONE 02/2013; 8(2):e56845. DOI:10.1371/journal.pone.0056845 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to understand how the presence of comorbid conditions affects retention in HIV medical care over time. A retrospective cohort design employing a medical chart review was conducted. A generalized linear mixed model was used to determine the predictors that affect retention over time. The mean follow-up for the study population was 5.75 years, and only 48.6 % achieved optimal retention. During the study period, 882 non-HIV related comorbidities were diagnosed in 610 (44.9 %) patients of whom, approximately 31 % had ≥2 comorbidities diagnosed. In the mixed model, the number of comorbidities diagnosed during the study period was associated with improved retention over time (odds ratio = 2.28; 95 % confidence interval = 1.83-2.71). Having a non-HIV related comorbid condition was associated with improved retention, while those patients who were 'healthier' had worse retention. More research is needed to identify factors that improve retention and to quantify the impact of these factors.
    AIDS and Behavior 05/2013; 18(3). DOI:10.1007/s10461-013-0524-y · 3.49 Impact Factor