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Severe Mental Illness and Retention in Anti-Retroviral Care: A Retrospective Study

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Abstract

Severe mental illness (SMI) in people living with HIV (PLWH) may impact on the initiation and adherence to combination antiretroviral treatment. We conducted a cross-sectional retrospective folder review of 100 PLWH suffering from an SMI, in Cape Town, South Africa. Information pertaining to whether these patients had attended a six-month visit at the referral HIV clinic after discharge from a psychiatric hospital was obtained. Of the 100 participants, 63 did not attend a first 6-month HIV clinic follow-up. There were no significant differences between 6-month attenders and non-attenders on demographic or clinical variables. After adjustment, respondents who had been re-admitted to a psychiatric hospital more than once were more likely not to attend their follow-up visit compared to those with no re-admissions (1 re-admission: PR = 1.52, 95 % CI 1.00–2.31; 2 or more re-admissions: PR = 1.60, 1.08–2.37). PLWH who have a co-morbid SMI are an especially vulnerable group of patients. Psychosocial support and interventions such as case management may be useful.

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Acknowledgments

JJ- has received support from the National Research Foundation of South Africa, the Biological Psychiatry special interest group of the South Africa Society of Psychiatrists, the Medical Research Council of South Africa and the Faculty of Health Sciences Research Committee, University of Cape Town. Pat Leighton, a fifth-year elective student from the University of Cape Town, initiated data collection.

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Authors and Affiliations

  1. Department of Psychiatry and Mental Health, Groote Schuur Hospital, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa

    John A. Joska & Katherine Sorsdahl

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Ade Obayemi Jr.

  3. Department of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa

    Henri Cararra

Authors
  1. John A. Joska
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  2. Ade Obayemi Jr.
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  3. Henri Cararra
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  4. Katherine Sorsdahl
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Correspondence to John A. Joska.

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Joska, J.A., Obayemi, A., Cararra, H. et al. Severe Mental Illness and Retention in Anti-Retroviral Care: A Retrospective Study. AIDS Behav 18, 1492–1500 (2014). https://doi.org/10.1007/s10461-014-0709-z

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  • DOI: https://doi.org/10.1007/s10461-014-0709-z

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