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Medical News & Perspectives | August 6, 2008

Integrated Care Needed for Patients With HIV, Drug Abuse, and Mental Illness

Bridget M. Kuehn

JAMA. 2008;300(5):494-495. doi:10.1001/jama.300.5.494.

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Patients who are infected with HIV and who also have simultaneous substance abuse problems and mental illness have complex medical and psychosocial needs that challenge traditional care models. But a growing body of research suggests that integrated care models may improve the quality of life for these patients and reduce further spread of the infection.

As many as half of individuals with substance abuse problems are estimated to have comorbid mental illness, and these dual-diagnosis patients have a relatively high risk of becoming infected with HIV. Studies have found that between 10% and 40% of patients at HIV clinics have a “triple diagnosis” of HIV, substance abuse disorder, and psychiatric illness, said Antoine Douaihy, MD, an associate professor of psychiatry at the University of Pittsburgh School of Medicine.

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Treating substance abuse has a collateral benefit of reducing HIV transmission. Researchers have found that opioid users who receive methadone treatment for their addiction are substantially less likely to become infected with HIV than are opioid users who are not in treatment.

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Kuehn BM. Integrated Care Needed for Patients With HIV, Drug Abuse, and Mental Illness. JAMA. 2008;300(5):494-495. doi:10.1001/jama.300.5.494.

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