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Does Diagnosis Make a Difference? Estimating the Impact of an HIV Medication Adherence Intervention for Persons with Serious Mental Illness

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Abstract

The heightened risk of persons with serious mental illness to contract and transmit human immunodeficiency virus (HIV) is a public health problem. Here we evaluate the interaction between psychiatric diagnosis and response to a community based-intervention targeted at treatment adherence in 236 HIV+ persons with co-occurring mental illness. To examine differential effectiveness of the intervention for categories of patient diagnosis, we reanalyzed the data after stratifying participants into two diagnostic groups: (1) participants with depressive disorders without psychosis and (2) participants with a psychotic or bipolar disorder. Outcomes included viral load and mental health quality of life (SF-12 Mental Health). We found that HIV+ persons with non-psychotic depressive disorders demonstrated a larger decrease in HIV viral load and more improvement in measures of mental health quality of life when compared to HIV+ persons with psychotic and bipolar disorders. We suggest that successful adherence interventions should be informed by psychiatric symptomatology. Trial registration: clinicaltrials.gov 29 identifier NCT00264823.

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Funding

This research was supported by Grants from National Institute on Drug Abuse (RO1-DA-015627 ‘‘HIV Prevention Program among Substance Abusing SMI”), the National Institute for Nursing Research (RO1-NR-008851 ‘‘Nursing Intervention for HIV Regimen: Adherence among SMI’’), Penn Mental Health AIDS Research Center (PMHARC - P30MH097488-04) and Penn Center for AIDS Research (CFAR - P30-AI-45008-18).

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Science, Lewis Katz School of Medicine, Temple University, Episcopal Campus, 100 E Lehigh Ave MAB 305, Philadelphia, PA, 19125, USA

    Natasha Dalseth

  2. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Regina Szucs Reed, Marlene M. Eisenberg & Michael B. Blank

  3. Campus Edge Advisors LLC, Branford, CT, USA

    Michael Hennessy

Authors
  1. Natasha Dalseth
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  2. Regina Szucs Reed
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  3. Michael Hennessy
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  4. Marlene M. Eisenberg
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  5. Michael B. Blank
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Correspondence to Natasha Dalseth.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Dalseth, N., Reed, R.S., Hennessy, M. et al. Does Diagnosis Make a Difference? Estimating the Impact of an HIV Medication Adherence Intervention for Persons with Serious Mental Illness. AIDS Behav 22, 265–275 (2018). https://doi.org/10.1007/s10461-017-1795-5

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  • DOI: https://doi.org/10.1007/s10461-017-1795-5

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