Psychiatric diagnoses in a sample of HIV-infected people of color in methadone treatment.
ABSTRACT Little diagnostic information is available for those who represent a significant part of the HIV epidemic: substance-using members of racial and ethnic minority communities. Our paper describes the rates of psychiatric diagnoses in a convenience sample of HIV-positive, African American and Hispanic clients in methadone treatment in the Bronx, NY. Out of 139 HIV-positive volunteers, 99 subjects had diagnoses in addition to opioid dependence on agonist therapy. The mean number of diagnoses was 3.84 (SD = 1.41). These findings confirm the need to target mental health as part of the national response to the HIV/AIDS epidemic in inner cities.
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ABSTRACT: Stigma is defined as the devaluation of a person due to the possession of a characteristic that has negative social meanings. Since the onset of the HIV/AIDS epidemic, living with HIV entails a social stigma. Research has documented stigma manifestations among health professionals. These manifestations are particularly dangerous since they might entail lack of services for people who live with HIV/AIDS (PLWHA). This study had as its goals to explore: (a) the perceived level of competence of students and health professionals for delivering services to PWLHA, (b) their opinions regarding their completed and needed training, and (c) the existence of stigmatizing attitudes towards PLWHA. The sample includes 80 participants (40 students and 40 professionals) from the fields of medicine, nursing, psychology and social work. Results evidence that participants have received training in HIV but these did not address important social issues such as myths, fears, and stigma. Implications to future research and for the development of interventions to address stigma in health scenarios is discussed.01/2008; 26(1):69-89.
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ABSTRACT: Effectiveness of HIV-related mental health practice in inner cities has not been adequately documented despite an urgent need for interventions for populations disproportionately affected by the epidemic. Practices must take into account and respond to cultural issues of people of colour and the needs of those infected through injection drug use or heterosexual sex with IDUs. We report the effectiveness of an HIV mental health programme integrated with primary care and emphasizing cultural responsiveness. A sample of 47 of 188 patients who received psychiatric and psychotherapy services was compared with other subjects. The 47 had an average of 8.34 encounters over an average of 36.23 weeks. Consumers of project services used mental health care at a higher rate than did comparison subjects. Regression analyses indicated that utilization was related to reduction in reported mental health problems, HIV-related physical symptoms, and use of alcohol and powdered cocaine, as well as to improvement in social functioning. Our clients, individuals often viewed as not likely to avail themselves of or benefit from mental health care, were highly motivated for self-improvement and, given access to competent, convenient and culturally respectful services, improved their well-being in significant domains.AIDS Care 09/2005; 17(6):747-56. DOI:10.1080/09540120412331336733 · 1.60 Impact Factor
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ABSTRACT: To study the prevalence of psychiatric comorbidity based on reference standard diagnostic criteria in patients with human immunodeficiency virus (HIV). Psychiatric illness is common in patients with HIV and has been associated with negative health behaviors and poorer clinical outcomes. Among those persons with psychiatric illness, psychiatric comorbidity (multiple simultaneous diagnoses) is associated with increased psychiatric severity and higher HIV risk behaviors. A total of 152 consecutively presenting HIV+ patients at an academic medical center in the southeastern US completed a modified Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition) that assessed mood, anxiety, and substance use disorders in the past year and past month. Fifty percent and 33% of patients had a past-year and past-month diagnosis, respectively. The most common diagnoses were mood disorders (32% past year/21% past month) followed by anxiety (21%/17%) and substance use disorders (22%/11%). Half of those with past-year disorders and 40% of those with past-month disorders met the criteria for multiple diagnoses. Of those with a mood disorder in the past month, 53% also had an anxiety or substance use disorder; of those with an anxiety disorder, 62% also had a mood or substance use disorder; and of those with a substance use disorder, 63% also had a mood or anxiety disorder. Psychiatric comorbidity was associated with younger age, White non-Hispanic race/ethnicity, and greater HIV symptomatology. Comorbidity of mood, anxiety, and substance use disorders was the exception rather than the rule in this sample. Potential co-occurring disorders should be considered for HIV+ patients presenting with a psychiatric diagnosis.Psychosomatic Medicine 06/2008; 70(4):505-11. DOI:10.1097/PSY.0b013e31816aa0cc · 4.09 Impact Factor