High Levels of Concomitant Behavioral Health Disorders Among Patients Presenting for HIV Non-occupational Post-exposure Prophylaxis at a Boston Community Health Center Between 1997 and 2013

Sachin Jain, Catherine E. Oldenburg, Matthew J. Mimiaga, Kenneth H. Mayer

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

A paucity of information regarding mental health exists for patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP). We reviewed electronic medical records of 894 adult nPEP patients seen at a large Boston community health center between 1997 and 2013. Of 821 patients with consensual sexual exposures, 88.3 % were men who have sex with men, and 40.0 % had a mental health diagnosis. Diagnoses included: depression (24.4 %), anxiety (21.9 %), attention deficit disorder (7.8 %), post-traumatic stress disorder (3.3 %), and psychotic disorders (3.3 %). Of 129 patients with substance use disorders, alcohol dependence (65.9 %) and crystal methamphetamine (43.4 %) predominated. Unprotected receptive anal intercourse was associated with psychotic disorders (aOR = 4.86; 95 %CI:1.76–13.5) and substance use disorders (aOR = 1.89; 95 %CI:1.28–2.80). Substance use at the time of exposure was associated with: depression (aOR = 1.95; 95 %CI:1.36–2.80), anxiety (aOR = 2.22; 95 %CI:1.51–3.25), attention deficit disorder (aOR = 1.96; 95 %CI:1.18–3.27), and substance use disorder (aOR = 4.78; 95 %CI:3.30–6.93). Mental illness should be screened for and addressed at nPEP visits to optimize HIV risk-reduction.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StateAccepted/In press - Feb 18 2015

Fingerprint

Post-Exposure Prophylaxis
Community Health Centers
HIV
Substance-Related Disorders
Health
Attention Deficit Disorder with Hyperactivity
Psychotic Disorders
Mental Health
Anxiety
Depression
Methamphetamine
Electronic Health Records
Risk Reduction Behavior
Post-Traumatic Stress Disorders
Alcoholism

Keywords

  • HIV
  • Mental illness
  • nPEP
  • PEP
  • Syndemic

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Social Psychology

Cite this

High Levels of Concomitant Behavioral Health Disorders Among Patients Presenting for HIV Non-occupational Post-exposure Prophylaxis at a Boston Community Health Center Between 1997 and 2013. / Jain, Sachin; Oldenburg, Catherine E.; Mimiaga, Matthew J.; Mayer, Kenneth H.

In: AIDS and Behavior, 18.02.2015.

Research output: Contribution to journalArticle

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abstract = "A paucity of information regarding mental health exists for patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP). We reviewed electronic medical records of 894 adult nPEP patients seen at a large Boston community health center between 1997 and 2013. Of 821 patients with consensual sexual exposures, 88.3 {\%} were men who have sex with men, and 40.0 {\%} had a mental health diagnosis. Diagnoses included: depression (24.4 {\%}), anxiety (21.9 {\%}), attention deficit disorder (7.8 {\%}), post-traumatic stress disorder (3.3 {\%}), and psychotic disorders (3.3 {\%}). Of 129 patients with substance use disorders, alcohol dependence (65.9 {\%}) and crystal methamphetamine (43.4 {\%}) predominated. Unprotected receptive anal intercourse was associated with psychotic disorders (aOR = 4.86; 95 {\%}CI:1.76–13.5) and substance use disorders (aOR = 1.89; 95 {\%}CI:1.28–2.80). Substance use at the time of exposure was associated with: depression (aOR = 1.95; 95 {\%}CI:1.36–2.80), anxiety (aOR = 2.22; 95 {\%}CI:1.51–3.25), attention deficit disorder (aOR = 1.96; 95 {\%}CI:1.18–3.27), and substance use disorder (aOR = 4.78; 95 {\%}CI:3.30–6.93). Mental illness should be screened for and addressed at nPEP visits to optimize HIV risk-reduction.",
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