AIDS and Behavior

, Volume 21, Issue 12, pp 3457–3463 | Cite as

Mental Health Disorders and Publicly Funded Service Use by HIV Positive Individuals: A Population-Based Cross-Sectional Study in Ontario, Canada

  • Anna Durbin
  • Hilary K. Brown
  • Tony Antoniou
  • Frank Sirotich
  • Symron Bansal
  • Marina Heifetz
  • Kay Roesslein
  • Yona Lunsky
Brief Report


We compared use of community and hospital-based mental health and addiction (MH&A) services by adults with and without HIV. This population-based study examined the probability and intensity of MH&A service use by individuals with (n = 5095) and without HIV (n = 2,753,091) in Ontario, Canada between 2013 and 2014. Adults with HIV were more likely than HIV-negative adults to use MH&A primary and psychiatric care, and to have MH&A emergency department visits and hospital admissions; they also used more of each service. Use of MH&A hospital services was particularly high for persons in the HIV group compared to the no HIV group.


Behavioral health Community-based care HIV Hospital care Mental disorders Mental health and addictions Service use 



Community health centres


Confidence interval


Emergency department


Human immunodeficiency virus


Mental health and addiction


Odds ratio



Parts of this material are based on data and information compiled and provided by Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the authors, and not necessarily those of CIHI. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual Grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred.


T. A. was supported by a CIHR New Investigator Award. This study was also supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario MOHLTC. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES is intended or should be inferred. Parts of this material are based on data and information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

10461_2017_1949_MOESM1_ESM.docx (39 kb)
Supplementary material 1 (DOCX 39 kb)


  1. 1.
    Galvan FH, Burnam MA, Bing EG. Co-occurring psychiatric symptoms and drug dependence or heavy drinking among HIV-positive people. J Psychoact Drugs. 2003;35(Suppl 1):153–60.CrossRefGoogle Scholar
  2. 2.
    Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Whetten K, Reif SS, Napravnik S, et al. Substance abuse and symptoms of mental illness among HIV-positive persons in the Southeast. South Med J. 2005;98(1):9–14.CrossRefPubMedGoogle Scholar
  4. 4.
    Tegger MK, Crane HM, Tapia KA, Uldall KK, Holte SE, Kitahata MM. The effect of mental illness, substance use, and treatment for depression on the initiation of highly active antiretroviral therapy among HIV-infected individuals. AIDS Patient Care STDS. 2008;22(3):233–43.CrossRefPubMedGoogle Scholar
  5. 5.
    Schade A, van Grootheest G, Smit JH. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients. BMC Psychiatry. 2013;13:35.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Lopes M, Olfson M, Rabkin J, et al. Gender, HIV status, and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2012;73(3):384–91.CrossRefPubMedGoogle Scholar
  7. 7.
    Burnam MA, Bing EG, Morton SC, et al. Use of mental health and substance abuse treatment services among adults with HIV in the United States. Arch Gen Psychiatry. 2001;58(8):729–36.CrossRefPubMedGoogle Scholar
  8. 8.
    Himelhoch S, Josephs JS, Chander G, Korthuis PT, Gebo KA. HIV Research Network. Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study. Gen Hosp Psychiatry. 2009;31(6):538–45.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Choi SK, Boyle E, Cairney J, et al. Adequacy of mental health services for HIV-positive patients with depression: Ontario HIV treatment network cohort study. PLoS ONE. 2016;11(6):e0156652.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Antoniou T, Zagorski B, Loutfy MR, Strike C, Glazier RH. Validation of case-finding algorithms derived from administrative data for identifying adults living with human immunodeficiency virus infection. PLoS ONE. 2011;6(6):e21748.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Steele LS, Glazier RH, Lin E, Evans M. Using administrative data to measure ambulatory mental health service provision in primary care. Med Care. 2004;42(10):960–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Durbin A, Moineddin R, Lin E, Steele LS, Glazier RH. Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study. BMJ Open. 2015;5(3):e006690.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ng R, Kendall C, Burchell AN, et al. Emergency department use by people with HIV in Ontario: a population-based cohort study. CMAJ Open. 2016;4:e240–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Thai TT, Jones MK, Harris LM, Heard RC. The association between symptoms of mental disorders and health risk behaviours in Vietnamese HIV positive outpatients: a cross-sectional study. BMC Public Health. 2017;17(1):250.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Springer SA, Dushaj A, Azar MM. The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review. AIDS Behav. 2012;16(8):2119–43.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Orellana ER, Goldbach J, Rountree MA, Bagwell M. Access to mental health and substance abuse services by people living with HIV/AIDS: the case manager perspective. Health Soc Work. 2015;40(2):e10–4.CrossRefGoogle Scholar
  17. 17.
    Kidder DP, Wolitski RJ, Campsmith ML, Nakamura GV. Health status, health care use, medication use, and medication adherence among homeless and housed people living with HIV/AIDS. Am J Public Health. 2007;97(12):2238–45.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Whetten K, Reif S, Ostermann J, et al. Improving health outcomes among individuals with HIV, mental illness, and substance use disorders in the Southeast. AIDS Care. 2006;18(Suppl 1):S18–26.CrossRefPubMedGoogle Scholar
  19. 19.
    Johnson D, Polansky M, Matosky M, Teti M. Psychosocial factors associated with successful transition into HIV case management for those without primary care in an urban area. AIDS Behav. 2010;14(2):459–68.CrossRefPubMedGoogle Scholar
  20. 20.
    Honagodu AR, Krishna M, Sundarachar R, Lepping P. Group psychotherapies for depression in persons with HIV: a systematic review. Indian J Psychiatry. 2013;55(4):323–30.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Collins PY, Holman AR, Freeman MC, Patel V. What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS. 2006;20(12):1571–82.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Scott VC, Kenworthy T, Godly-Reynolds E, et al. The readiness for integrated care questionnaire (RICQ): an instrument to assess readiness to integrate behavioral health and primary care. Am J Orthopsychiatr. 2017;87:520.CrossRefGoogle Scholar
  23. 23.
    Durbin A, Durbin J, Hensel JM, Deber R. Barriers and enablers to integrating mental health into primary care: a policy analysis. J Behav Health Serv Res. 2013;43:127–39.CrossRefGoogle Scholar
  24. 24.
    Muggah E, Dahrouge S, Hogg W. Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada. BMC Fam Pract. 2012;13:128.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Centre for Urban Health Solutions, Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  2. 2.Institute for Clinical Evaluative SciencesTorontoCanada
  3. 3.Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.Interdisciplinary Centre for Health and SocietyUniversity of Toronto ScarboroughScarboroughCanada
  5. 5.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  6. 6.Women’s College Research InstituteWomen’s College HospitalTorontoCanada
  7. 7.Department of Family and Community MedicineSt. Michael’s HospitalTorontoCanada
  8. 8.Department of Family and Community MedicineUniversity of TorontoTorontoCanada
  9. 9.Research and Evaluation, Canadian Mental Health Association–Toronto BranchTorontoCanada
  10. 10.Faculty of Social WorkUniversity of TorontoTorontoCanada
  11. 11.Centre for Addiction and Mental HealthTorontoCanada
  12. 12.LOFT Community Services/McEwan Housing & Support ServicesTorontoCanada

Personalised recommendations