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Association Between Substance Abuse and Mental Illness Symptoms Screener (SAMISS) Scores and HIV Care Continuum Outcomes in People Newly Diagnosed with HIV in the US South

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Abstract

Mental illness (MI) and substance use (SU) are highly prevalent among people with HIV (PWH) and impact care outcomes. The Substance Abuse and Mental Illness Symptoms Screener (SAMISS) is a validated screener for MI and SU, but it is unknown how screening results at entry to care correlate with subsequent HIV outcomes. This is a retrospective chart review of individuals newly diagnosed with HIV between 2016 and 2019 in a Southern US, safety-net clinic. Baseline demographics, HIV risk factors, socioeconomic variables, and SAMISS screening scores were collected. Outcomes included retention in care, achieving virologic suppression (VS), and continuous VS. Data analyses included stepwise Cox and logistic multivariate regression modeling. Among the 544 newly diagnosed PWH, mean age was 35, 76% were male, 46% non-Hispanic Black, 40% Hispanic/other. Overall, 35% screened positive for SU and 41% for MI. A positive SU (odds ratio (OR) 0.66, p = 0.04) or MI (OR 0.65, p = 0.03) SAMISS screening was associated with lower retention in care in univariate analysis, but was not statistically significant after adjusting for other variables. Positive SAMISS screening for SU and MI were both associated with reduced continuous VS in univariate and multivariate analyses (SU: adjusted OR (aOR) 0.67, p = 0.05; MI: aOR 0.66, p = 0.03). SAMISS is a useful tool for prospectively identifying individuals at risk for low retention in care and for not achieving sustained VS. Future interventions guided by SAMISS may improve HIV care continuum outcomes.

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Funding

This project is funded by an investigator sponsored research grant (IN-US-380-5711) from Gilead Sciences awarded to Dr. Chow and Dr. Nijhawan.

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  1. University of Texas Southwestern Medical School, Dallas, TX, USA

    Manal Ahmed

  2. Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ank E. Nijhawan & Jeremy Y Chow

  3. Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ank E. Nijhawan, Ang Gao, Chul Ahn & Jeremy Y Chow

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Correspondence to Jeremy Y Chow.

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Ank E. Nijhawan, MD, MPH, MSCS, Gilead Sciences: Grant/Research Support Jeremy Y. Chow, M.D., M.S., Gilead Sciences: Grant/Research Support.

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Ahmed, M., Nijhawan, A.E., Gao, A. et al. Association Between Substance Abuse and Mental Illness Symptoms Screener (SAMISS) Scores and HIV Care Continuum Outcomes in People Newly Diagnosed with HIV in the US South. AIDS Behav 28, 1731–1740 (2024). https://doi.org/10.1007/s10461-024-04287-1

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