Objectives: National prevalence studies of mental disorders estimate that nearly half of HIV-infected persons in the U.S. have probable psychiatric disorders and 70% are in need of mental health care. However, no one has comprehensively examined factors related to mental health service utilization or mental health service intensity, or factors related to clients' satisfaction with mental health service providers among HIV-positive persons nationally. This study examined relationships between these outcomes and individual, facility/provider, and environmental factors among a cross- sectional, nationally representative sample of HIV-positive adults. Methods: Data were from the HIV Cost and Services Utilization Study (HCSUS) conducted in 1996-7. This is the first survey to randomly select and interview a nationally representative sample of adults in regular medical care for HIV. Subjects in this analysis either perceived need for mental health care or met criteria for psychiatric diagnoses (n=1046). Andersen's Behavioral Model of Health Services Use, a widely used framework to study health service utilization, was applied in this analysis. The HCSUS mental health survey used included a structured psychiatric diagnostic interview to determine common and major psychiatric disorders. Standard multivariate regressions and multi-level analysis (using HLM) were used to account for the clustered sampling and hierarchical nature of the data. Results: The results presented will include specific environmental, provider/facility and individual factors related to receiving: any mental health care; taking psychotherapeutic medications, receiving psychiatric inpatients stays, and receiving mental health visits; receiving more intense mental health services; and clients' satisfaction with mental health services providers.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. List the most influential environmental, provider/facility and individual factors related to receiving any or specific mental health services and to clients' satisfaction with care for people with HIV/AIDS. 2. Use this information to develop more effective interventions to increase the number of HIV-positive persons in need of mental health care who receive it.
Keywords: Access to Care, Mental Illness
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.