Use of Mental Health and Substance Abuse Treatment Services Among Adults With HIV in the United States

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Abstract
SEVERAL STUDIES suggest that adults infected with human immunodeficiency virus (HIV) are more likely than those in the general community to experience depression and anxiety and to have a history of substance abuse (E.G.B., M.A.B., Douglas Longshore, PhD, et al, unpublished data, 2001).1-3 Excess prevalence of psychiatric disorder among persons with HIV may reflect high rates of preexisting affective and substance abuse disorder in demographic groups at the highest risk for HIV.3-7 There is also evidence, however, that anxiety, depression, and emotional distress may for some be a response to the initial crisis of learning that they are seropositive or to subsequent symptoms and disability associated with HIV-related illness.3,5 Regardless of its origins, the presence of significant emotional distress, psychiatric disorder, or substance abuse among persons with HIV may impede the use of medical services and adherence to HIV medication regimens8,9 and increase the physical and emotional burden of care provided by formal and informal caregivers.