Syndemic effect of mental illness and substance use on viral suppression among recently-incarcerated,HIV-infected individuals in the CARE+ Corrections study |
| |
Authors: | Hannah Yellin Curt Beckwith Ann Kurth Tao Liu Breana Castonguay Rudy Patrick |
| |
Affiliation: | 1. Department of Epidemiology and Biostatistics, George Washington University, Milken Institute School of Public Health, Washington, DC, USAhttp://orcid.org/0000-0002-4880-3270;2. Division of Infectious Diseases, The Miriam Hospital, Providence, RI, USA;3. Division of Infectious Diseases, Brown University Alpert School of Medicine, Providence, RI, USA;4. Yale University School of Nursing, New Haven, CT, USA;5. Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA;6. Department of Epidemiology and Biostatistics, George Washington University, Milken Institute School of Public Health, Washington, DC, USA |
| |
Abstract: | Few studies on HIV-related syndemics of co-occurring and mutually reinforcing psychosocial conditions have assessed clinical outcomes in criminal justice (CJ)-involved populations. Baseline data from the CARE+ Corrections study were used to quantify co-occurring mental illness and substance use and examine syndemic effects on viral suppression among 106 CJ-involved HIV-infected individuals. Ninety-one (86%) reported a mental illness diagnosis, 30 (28%) reported hazardous alcohol use, and 61 (58%) were drug dependent. Eighteen (17%) experienced all three conditions. Drug dependence was clustered with mental illness (prevalence odds ratio [POR] 3.20, 95% CI 1.01–10.14) and hazardous alcohol use (POR 2.61, 95% CI 1.03–6.56). The association between syndemic score, representing the number of conditions reported by each individual, and viral suppression was not statistically significant, although 86% of participants with none of these conditions were virally suppressed, compared to 56% of those with all three (p?=?0.56). Mental illness and substance use were concentrated in this sample, indicating a need for integrated care services. |
| |
Keywords: | Criminal justice system HIV syndemics mental illness substance use |
|
|