mental health AIDS

Winter 2007 Newsletter / Volume 8, Issue 2

Resources

Books & Articles

Chander, G., Himelhoch, S., & Moore, R.D. (2006). Substance abuse and psychiatric disorders in HIV-positive patients: Epidemiology and impact on antiretroviral therapy. Drugs, 66(6), 769-789.

Chander, Himelhoch, and Moore "reviewed the English language literature on (i) the prevalence of alcohol and illicit drug use, mental health disorders and co-occurring mental health and substance use disorders in HIV-infected individuals; (ii) their effect on antiretroviral efficacy/effectiveness and adherence; and (iii) interventions to improve antiretroviral effectiveness and adherence in these populations" (p. 770).

Davies, G., Koenig, L.J., Stratford, D., Palmore, M., Bush, T., Golde, M., Malatino, E., Todd-Turner, M., & Ellerbrock, T.V. (2006). Overview and implementation of an intervention to prevent adherence failure among HIV-infected adults initiating antiretroviral therapy: Lessons learned from Project HEART. AIDS Care, 18(8), 895-903.

"Project HEART, an acronym for Helping Enhance Adherence to Retroviral Therapy, was a prospective, controlled study to develop, implement, and evaluate a clinic-based behavioural intervention to prevent adherence failure among HIV-infected adults beginning their first highly active antiretroviral therapy (HAART) regimen ... . In this paper, we describe the conceptualisation and components of the HEART intervention, characteristics of the participants and the contexts within which they were implementing their first HAART regimen, and lessons learned implementing HEART, particularly with respect to the formal use of support partners" (p. 895).

Harshbarger, C., Rebchook, G., O'Donnell, L., & Collins, C. (Eds.). (2006). Moving science into practice: The role of technology exchange for HIV/STD prevention. AIDS Education & Prevention, 18(Suppl. A), 1-197.

"This special supplement ... describes the Centers for Disease Control and Prevention's (CDC's) national Diffusion of Effective Behavioral [I]nterventions (DEBI) project and discusses the adoption, adaptation, and implementation of evidence-based HIV prevention interventions by health departments and community-based organizations (CBOs)" (p. 1).

Haug, N.A., Sorensen, J.L., Gruber, V.A., Lollo, N., & Roth, G. (2006). HAART adherence strategies for methadone clients who are HIV-positive: A treatment manual for implementing contingency management and medication coaching. Behavior Modification, 30(6), 752-781.

"This article outlines intervention strategies to improve medication adherence among clients who are in methadone maintenance. In this treatment manual, the authors delineate contingency management procedures, including voucher incentives and a fishbowl lottery prize system. They also describe intervention elements and adherence tools for medication coaching. The purpose of this manual is to describe the intervention procedures for clinicians and to serve as a resource for drug abuse treatment programs that serve clients who are HIV-positive" (p. 752).

Highstein, G.R., Willey, C., & Mundy, L.M. (2006). Development of stage of readiness and decisional balance instruments: Tools to enhance clinical decision-making for adherence to antiretroviral therapy. AIDS & Behavior, 10(5), 563-573.

"This study presents the development of Stage of Readiness (SOR) and decisional balance instruments based on the Transtheoretical Model of Behavior Change (TTM) to improve adherence to antiretroviral therapy (ART). ... Baseline stage of change and decisional balance scores prospectively predicted 1-year viral load level, thus identifying participants in need of adherence support interventions. Use of these instruments can give a provider added objective data on which to base a decision to either prescribe ART immediately or to first implement an intervention tailored to enhance this patient's readiness to adhere" (p. 563).

Mannheimer, S.B., Mukherjee, R., Hirschhorn, L.R., Dougherty, J., Celano, S.A., Ciccarone, D., Graham, K.K., Mantell, J.E., Mundy, L.M., Eldred, L., Botsko, M., & Finkelstein, R. (2006). The CASE Adherence Index: A novel method for measuring adherence to antiretroviral therapy. AIDS Care, 18(7), 853-861.

The Center for Adherence Support Evaluation (CASE) Adherence Index "is a composite measure composed of three simple questions addressing three different aspects of ART adherence: difficulty taking ART medication on time, frequency of missed ART doses and time since most recent missed ART dose" (p. 859). In this study, "the CASE Adherence Index was a better predictor of HIV ... [viral load] than three-day self-report. The index also ... performed as well as three-day self-report as a predictor of CD4 [cell] counts. The CASE Adherence Index's ease and speed of administration suggest that it is a useful tool for assessing ART adherence as part of routine clinical assessment in standard HIV care" (p. 860).

Olatunji, B.O., Mimiaga, M.J., O'Cleirigh, C., & Safren, S.A. (2006). Review of treatment studies of depression in HIV. Topics in HIV Medicine, 14(3), 112-124.

"This article is a review of the existing literature on the treatment of depression in the context of HIV, including: (1) psychosocial and behavioral health interventions that directly target Diagnostic and Statistical Manual of Mental Disorders (DSM) unipolar depressive disorders, (2) psychosocial interventions that indirectly target depressive symptoms, and (3) psychopharmacologic treatment studies for DSM-IV unipolar depressive disorders. ... Because of the high frequency of depression comorbid with HIV, and the association of depression with important self-care behaviors in this population, identification of efficacious treatments for depression has the potential to improve both overall quality of life and, potentially, health outcomes" (p. 112).

Prado, G., Schwartz, S.J., Pattatucci-Aragón, A., Clatts, M., Pantin, H., Fernández, M.I., Lopez, B., Briones, E., Amaro, H., & Szapocznik, J. (2006). The prevention of HIV transmission in Hispanic adolescents. Drug & Alcohol Dependence, 84(Suppl. 1), S43-S53.

"This article reviews the state of the science in HIV prevention for Hispanic adolescents. ... Literature is reviewed in three broad areas: (1) the prevalence rates of drug and alcohol misuse, sexual practices, and HIV infection; (2) risk and protective factors for drug and alcohol misuse and unprotected sex (in general and specifically for Hispanics); and (3) the state of HIV prevention intervention development and evaluation targeting Hispanic youth" (p. S43).

Shernoff, M. (2006). Negotiated nonmonogamy and male couples. Family Process, 45(4), 407-418.

"One issue that has the potential to confound family or couples therapists working with male couples is the issue of nonmonogamy. For many therapists, sexual nonexclusivity challenges fundamental clinical assumptions that 'affairs,' or extra-relationship sex or romantic involvements, are symptoms of troubled relationships and are always a form of 'sexual acting out.' This article explores the issue of sexual exclusivity and nonexclusivity within male couples. In order to achieve both clinical and cultural competency in work with male couples, therapists need to challenge their cultural biases regarding monogamy" (p. 407).

Tsevat, J. (Ed.). (2006). Spirituality/religion and quality of life in patients with HIV/AIDS. Journal of General Internal Medicine, 21(Suppl. 5), S1-S68.

"Collectively, the 8 papers in this supplement present a state-of-the-art look at both quality of life and spirituality/religion from 2 longitudinal studies involving a total of 550 patients with HIV from Cincinnati, OH, Washington, DC, Pittsburgh, PA, and Miami, FL" (p. S1).


Whetten, K., Reif, S., Ostermann, J., Pence, B.W., Swartz, M., Whetten, R., Conover, C., Bouis, S., Thielman, N., & Eron, J. (2006). Improving health outcomes among individuals with HIV, mental illness, and substance use disorders in the Southeast. AIDS Care, 18(Suppl. 1), S18-S26.

"This article describes the results of a study that provided integrated behavioral health treatment of triply diagnosed adults residing in rural and urban North Carolina. The treatment model ... was created to meet the specific needs of triply diagnosed individuals" (p. S19). Over a 1-year period, Whetten and colleagues "detected statistically significant decreases in participants' psychiatric symptomatology, illicit substance use, alcohol use, and inpatient hospital days. Participants also reported fewer emergency room visits and were more likely to be receiving antiretroviral medications and adequate psychotropic medication regimens at follow-up. No changes in sexual risk, physical health, or medical adherence were detected after treatment participation. This integrated treatment model offers an option for treating HIV-infected individuals with mental health and substance use disorders that can be adapted for use in a variety of psychiatric and medical treatment settings" (p. S18).

On the Web

The New York State Department of Health AIDS Institute, in collaboration with the Johns Hopkins University Division of Infectious Diseases, has produced a new set of treatment guidelines entitled "Adherence to Antiretroviral Therapy Among HIV-Infected Patients with Mental Health Disorders," located at http://www.hivguidelines.org/Content.aspx.

– Compiled by Abraham Feingold, Psy.D.

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