Prevalence, incidence, and persistence of psychiatric and substance use disorders among mothers living with HIV

Kathleen M. Malee*, Claude A. Mellins, Yanling Huo, Katherine Tassiopoulos, Renee Smith, Patricia A. Sirois, Susannah M. Allison, Deborah Kacanek, Suad Kapetanovic, Paige L. Williams, Mitzie L. Grant, Daniel Marullo, Angela A. Aidala

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Objective: To evaluate prevalence, incidence, remission, and persistence of psychiatric and substance use disorders among HIVinfected mothers and identify biopsychosocial correlates. Methods: HIV-infected mothers (n = 1223) of HIV-exposed uninfected children enrolled in a prospective cohort study; HIVuninfected mothers (n = 128) served as a comparison group. Mothers provided sociodemographic and health information and completed the Client Diagnostic Questionnaire (CDQ). Prevalence of any psychiatric or substance use disorder at initial evaluation was compared between the 2 groups. Incident, remitting, and persisting disorders were identified for 689 mothers with HIV who completed follow-up CDQs. We used logistic regression to evaluate adjusted associations of biopsychosocial characteristics with presence, incidence, remission, and persistence of disorders. Results: Thirty-five percent of mothers screened positive for any psychiatric or substance use disorder at initial evaluation, with no difference by maternal HIV status (P = 1.00). Among HIV-infected mothers, presence of any disorder was associated with younger age [adjusted odds ratio (aOR): 1.39; 95% CI: 1.09 to 1.75], single parenthood (aOR: 1.35; 95% CI: 1.08 to 1.68), and functional limitations (aOR: 2.29; 95% CI: 1.81 to 2.90). Incident disorders were associated with functional limitations (aOR: 1.92; 95% CI: 1.10 to 3.30). Among HIV-infected mothers with a disorder at initial evaluation (n = 238), 61% had persistent disorders. Persistent disorders were associated with lower income (aOR: 2.44; 95% CI: 1.33 to 4.76) and functional limitations (aOR: 3.19; 95% CI: 1.87 to 5.48). Receipt of treatment for any disorder was limited: 4.5% at study entry, 7% at follow-up, 5.5% at both entry and follow-up. Conclusions: Psychiatric and substance use disorders remain significant comorbid conditions among HIV-infected mothers and require accessible evidence-informed treatment.

Original languageEnglish (US)
Pages (from-to)526-534
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume65
Issue number5
DOIs
StatePublished - Apr 15 2014

Keywords

  • HIV
  • Prevalence
  • Psychiatric disorder
  • Substance use disorders
  • Women

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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