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 Scopus citations

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)
Pages (from-to)1556-1563
Number of pages8
JournalAIDS and Behavior
Volume20
Issue number7
DOIs
StatePublished - Jul 1 2016

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Keywords

  • HIV
  • Mental illness
  • PEP
  • Syndemic
  • nPEP

ASJC Scopus subject areas

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

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