The 130th Annual Meeting of APHA

Abstract #47389

Judith A. Cook, PhD¹, Jane Burke, MS¹, Dennis D. Grey, BA¹, and Mardge H. Cohen, MD². (1) Department of Psychiatry/Mental Health Services Research Program, University of Illinois at Chicago, 104 South Michigan Ave, Suite 900, Chicago, IL 60603, (312)422-8180 x19, cook@ripco.com, (2) Cook County Hospital, 2020 W. Harrison St, Chicago, IL 60612

Background: This study explored associations between HIV care, mental health, chemical dependency, and disease progression among a national cohort of HIV-positive women.

Methods: Thirteen waves of semiannual data from a U.S. multicenter cohort study of HIV+ women were analyzed (N=1510). Disease progression was operationalized as change in CD4 cell count computed by regressing CD4 levels on time in study, and using standardized beta coefficients to represent the slope of CD4 cell count change. Mental health was assessed as the number of study visits at which respondents reported poor quality of life on the MOS-36. Chemical dependency was operationalized as use of crack/cocaine/heroin. HIV care included use of highly active antiretroviral therapy (ART), combination ART, and monotherapy (versus no ART). Hierarchical ordinary least-squares regression was used to examine the relationship between these variables, controlling for clinical and demographic factors.

Results: Poor mental health and chemical dependency were positively associated with greater CD4 lymphocyte decline, while HIV care was negatively associated with disease progression, controlling for relevant factors. Also negatively associated with disease progression was being hispanic/latina, being a high school graduate, number of HIV-related symptoms, and being older.

Conclusions: Given significant associations between disease progression, mental health, chemical dependency, and HIV care, services that address women's needs in these areas simultaneously may have an impact on CD4 lymphocyte decline. Ways in which services can be organized to complement and reinforce each other are discussed as part of comprehensive clinical care for women with HIV.

Learning Objectives:

• Describe the associations between mental health, chemical dependency, and disease progression.
• Describe the associations between HIV care and disease progression.
• Identify ways in which HIV care can be integrated with mental health and chemical dependency services.

Keywords: Women and HIV/AIDS, HIV Interventions

Presenting author's disclosure statement:
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.