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284876
Disparities in HAART discontinuation and treatment outcomes among individuals with HIV/AIDS and a comorbid serious mental illness


Wednesday, November 6, 2013

Lauren Wagner, MS, PhD Candidate, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Susan dosReis, PhD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Fran├žoise Pradel, PhD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Robert Beardsley, PhD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Clayton Brown, PhD, Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD
Background: The extent of race or age disparities in highly active antiretroviral therapy (HAART) discontinuation among individuals with HIV/AIDS and a comorbid serious mental illness (SMI) is unknown. The objectives of this study were to describe racial and age differences in HAART use in this population and identify gaps in research on disparities in HAART discontinuation and treatment outcomes by race and age. Methods: A comprehensive review was undertaken using data from the Centers for Disease Control and Prevention, scientific publications, and data from the HIV Research Network (HIVRN). The findings were summarized and used to inform an investigation that explores disparities in HAART discontinuation and treatment outcomes using HIVRN data. Results: HIV mortality is greater for individuals with HIV and a comorbid SMI. Significant race by age differences exist. HIV mortality among Blacks aged 25-34 is 10 times greater compared to Whites aged 25-34 (12.3 vs. 1.2 per 100,000). Data from the HIVRN from 2000-2009 show a smaller proportion of Blacks use HAART than Whites. There was 4.6% difference in HAART use between Blacks and Whites. Conclusions: Large disparities in HAART use between Blacks and Whites are consistent with large differences in HIV mortality. There is essentially no data on HAART discontinuation and subsequent health outcomes, such as hospitalization. There are considerable gaps in existing research on HAART and health service utilization for individuals with HIV and a comorbid SMI. Further research is needed to determine the public health impact of HAART discontinuation on hospitalization due to immunocompromised conditions.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe racial and age differences in HAART use in those diagnosed with HIV/AIDS and a comorbid serious mental illness (SMI). Identify gaps in research on disparities in HAART discontinuation and treatment outcomes by race and age.

Keyword(s): HIV/AIDS, Mental Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD Candidate at the University of Maryland School of Pharmacy in the Department of Pharmaceutical Health Services Research. My research interests throughout undergraduate and graduate school have been in disparities and HIV/AIDS. I am completing the current study as a part of my doctoral dissertation. I am hopeful that this work will begin my career as a disparities researcher and contribute to the field. I also volunteer for several HIV/AIDS organizations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5008.0: HIV and mental health