2.50
Hdl Handle:
http://hdl.handle.net/10755/163589
Category:
Abstract
Type:
Presentation
Title:
Mental illness, substance abuse and antiretroviral adherence
Author(s):
Bova, Carol; Fennie, Kristopher; Williams, Ann
Author Details:
Carol Bova, Assistant Professor, University of Massachusetts Medical School, Princeton, Massachusetts, USA, email: carol.bova@umassmed.edu; Kristopher Fennie; Ann Williams
Abstract:
Purpose: The purpose of this study is to improve understanding of the relationship between mental illness, substance abuse and antiretroviral adherence among HIV-infected adults. Specific Aims: 1. To describe the prevalence of mental illness, substance abuse and dual diagnosis (mental illness and substance abuse). 2. To describe the relationship among mental illness, substance abuse, dual diagnosis and antiretroviral (ARV) adherence in a cohort of HIV-infected adults. Methods: This is a cross-sectional descriptive study of subjects at entry to a prospective clinical trial. Data were collected in face-to-face interviews using a structured questionnaire. Measures include demographics, CES-D score for depressive symptoms, self-report of medication adherence for 3 days prior to the baseline interview, mental illness and substance abuse history, and results of electronic monitoring of medication bottle opening. Medication bottle openings were monitored for 4 weeks prior to interview. Descriptive statistics were used to summarize responses to the demographic, mental illness and substance abuse items. Mental illness and substance abuse variables were compared to self reported adherence using Chi Square and electronic monitoring adherence using ANOVA. Results: The sample includes 172 HIV positive adults currently taking highly active antiretroviral therapy. Nearly half of the sample are women (48.3%) and more than half are racial/ethnic minorities (35% African American, 19% Hispanic, 2% Native American, 2% other and 42% White). Thirty-six percent have a diagnosis of AIDS. The majority reported a history of substance abuse (75%) and mental illness (72%). Fifty-six percent reported coexisting mental illness and substance abuse(dual diagnosis). The most frequently reported mental illness was depression (61%). Fortynine percent reported current depressive symptoms, despite the fact that 62.5% of those with depression were on antidepressant therapy. In addition, 36% reported at least one suicide attempt. Sixty percent of those attempting suicide reported that HIV infection was not an important factor in their suicide attempt. Substance abuse prevalence was high: alcohol (39.1%), heroin (36%), crack (35.5%) and cocaine (33.7%). Subjects self reported taking 86% of prescribed antiretroviral medication doses. Electronic measurement demonstrated that 72% of prescribed doses were taken. However, only 64% by self-report and 36% by electronic measure reached the target of 95% or better ARV adherence. No relationship was found between ARV adherence at baseline (by either electronic monitoring or self report) and depression, mental illness, substance abuse (prior and active) or being dually diagnosed. Conclusions: The prevalence of comorbid mental illness and substance abuse is high among HIV positive outpatients. No relationships were found among mental illness, substance abuse and antiretroviral adherence. There was a significant difference in adherence rates according to electronic measurement and self-report measures. Implications for Nursing Practice and Knowledge Development: These data clearly illustrate the need to aggressively screen HIV-positive outpatients for the presence of coexisting mental illness (especially depression) and substance abuse. The influence of these comorbid conditions on ARV adherence over time deserves further evaluation.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleMental illness, substance abuse and antiretroviral adherenceen_GB
dc.contributor.authorBova, Carolen_US
dc.contributor.authorFennie, Kristopheren_US
dc.contributor.authorWilliams, Annen_US
dc.author.detailsCarol Bova, Assistant Professor, University of Massachusetts Medical School, Princeton, Massachusetts, USA, email: carol.bova@umassmed.edu; Kristopher Fennie; Ann Williamsen_US
dc.identifier.urihttp://hdl.handle.net/10755/163589-
dc.description.abstractPurpose: The purpose of this study is to improve understanding of the relationship between mental illness, substance abuse and antiretroviral adherence among HIV-infected adults. Specific Aims: 1. To describe the prevalence of mental illness, substance abuse and dual diagnosis (mental illness and substance abuse). 2. To describe the relationship among mental illness, substance abuse, dual diagnosis and antiretroviral (ARV) adherence in a cohort of HIV-infected adults. Methods: This is a cross-sectional descriptive study of subjects at entry to a prospective clinical trial. Data were collected in face-to-face interviews using a structured questionnaire. Measures include demographics, CES-D score for depressive symptoms, self-report of medication adherence for 3 days prior to the baseline interview, mental illness and substance abuse history, and results of electronic monitoring of medication bottle opening. Medication bottle openings were monitored for 4 weeks prior to interview. Descriptive statistics were used to summarize responses to the demographic, mental illness and substance abuse items. Mental illness and substance abuse variables were compared to self reported adherence using Chi Square and electronic monitoring adherence using ANOVA. Results: The sample includes 172 HIV positive adults currently taking highly active antiretroviral therapy. Nearly half of the sample are women (48.3%) and more than half are racial/ethnic minorities (35% African American, 19% Hispanic, 2% Native American, 2% other and 42% White). Thirty-six percent have a diagnosis of AIDS. The majority reported a history of substance abuse (75%) and mental illness (72%). Fifty-six percent reported coexisting mental illness and substance abuse(dual diagnosis). The most frequently reported mental illness was depression (61%). Fortynine percent reported current depressive symptoms, despite the fact that 62.5% of those with depression were on antidepressant therapy. In addition, 36% reported at least one suicide attempt. Sixty percent of those attempting suicide reported that HIV infection was not an important factor in their suicide attempt. Substance abuse prevalence was high: alcohol (39.1%), heroin (36%), crack (35.5%) and cocaine (33.7%). Subjects self reported taking 86% of prescribed antiretroviral medication doses. Electronic measurement demonstrated that 72% of prescribed doses were taken. However, only 64% by self-report and 36% by electronic measure reached the target of 95% or better ARV adherence. No relationship was found between ARV adherence at baseline (by either electronic monitoring or self report) and depression, mental illness, substance abuse (prior and active) or being dually diagnosed. Conclusions: The prevalence of comorbid mental illness and substance abuse is high among HIV positive outpatients. No relationships were found among mental illness, substance abuse and antiretroviral adherence. There was a significant difference in adherence rates according to electronic measurement and self-report measures. Implications for Nursing Practice and Knowledge Development: These data clearly illustrate the need to aggressively screen HIV-positive outpatients for the presence of coexisting mental illness (especially depression) and substance abuse. The influence of these comorbid conditions on ARV adherence over time deserves further evaluation.en_GB
dc.date.available2011-10-27T11:10:13Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:10:13Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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