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Does HIV serostatus affect outcomes of dually diagnosed opiate dependents in residential treatment?

Published online by Cambridge University Press:  18 May 2011

Giuseppe Carrà ,
Cristina Montomoli ,
Maria Cristina Monti  and
Massimo Clerici
Giuseppe Carrà
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, London (UK)
Cristina Montomoli
Affiliation:
Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia (Italy)
Maria Cristina Monti
Affiliation:
Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia (Italy)
Massimo Clerici*
Affiliation:
Department of Neuro sciences and Biomedical Technologies, University of Milano, Bicocca Medical School
*
Address for correspondence: Prof. M. Clerici, Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca Medical School, Via Pergolesi 33, 20052 Monza (Italy). Fax: +39(0)2 4547 1850 E-mail: massimo.clerici@unimib.it
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Summary

Backgroung – Little is known about specific treatment needs of mentally ill clients abusing substances and infected by HIV. The major gap concerns residential programmes. Aims – To explore differences in outcomes between seropositive and seronegative dually diagnosed opiate dependent clients who participated in a residential therapy programme. Methods – Data were gathered on 154 clients treated in a therapeutic community in Milan between October 1999 and September 2004. Odds ratios with 95% confidence intervals were used to study the association between HIV serostatus and outcome. Results – At 12-month follow-up, seropositive clients were more likely to relapse. Conclusions – The impact of HIV seropositivity on behavioural outcomes should be taken into consideration when planning residential programmes for the HIV (+) dually diagnosed population. Further research could test the need of incorporating dedicated treatments into existing programmes.

Declaration of interest: None.

Keywords

Seropositivityopiate dependencemental disorderstherapeutic community
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 1 , March 2008 , pp. 77 - 81
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychiatric Association: Washington DC.Google Scholar
Baigent, M.F. (2003). Physical complications of substance abuse: what the psychiatrist needs to know. Current Opinion in Psychiatry 16, 291–296.CrossRefGoogle Scholar
Bizzarri, J.V., Rucci, P., Casalboni, D., Randi, S., Tattini, M., Girelli, M, Pojer, F. & Sbrana, A. (2007). Substance use and psychiatric symptoms in subjects referred to the Drug Addiction Services by the prefecture. Epidemiologia e Psichiatria Sociale 16, 73–78.CrossRefGoogle Scholar
Carrà, G. & Clerici, M. (2003). The Italian Association on Addiction Psychiatry (SIP Dip), formerly The Italian Association on Abuse and Addictive Behaviours. Addiction 98, 1039–1042.CrossRefGoogle Scholar
Carrà, G. & Clerici, M. (2006). Dual diagnosis: policy and practice in Italy. American Journal on Addictions 15, 144–149.CrossRefGoogle ScholarPubMed
Carrà, G., Scioli, R., Monti, M.C. & Marinoni, A. (2006). Severity profiles of substance-abusing patients in Italian community addiction facilities: influence of psychiatric concurrent disorders. European Addiction Research 12,96–101.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC) (1999). Communitylevel HIV intervention in 5 cities: Final outcome data from the CDC AIDS Community Demonstration Projects. American Journal of Public Health 89, 336–345.CrossRefGoogle Scholar
Clayton, D. & Hills, M. (1993). Statistical Models in Epidemiology. Oxford University Press: Oxford.Google Scholar
Crawford, V., Crome, I.B. & Clancy, C. (2003). Co-existing problems of mental health and substance misuse (Dual Diagnosis): a literature review. Drugs: Education, Prevention and Policy 10, Suppl. 1, 1–74.Google Scholar
Crome, I.B. (2000). Dissemination of current treatment research findings to the profession, policy makers and patients-whose responsibility is it? Addiction 95, 1767–1769.Google Scholar
De Leon, G., Sacks, S., Staines, G. & McKendrick, K. (2000). Modified therapeutic community for homeless mentally ill chemical abusers: treatment outcomes. American Journal of Drug and Alcohol Abuse 26,461–480.CrossRefGoogle ScholarPubMed
Egelko, S., Galanter, M., Dermatis, H., Jurewicz, E., Jamison, A., Dingle, S. & De Leon, G. (2002). Improved psychological status in a modified therapeutic community for homeless MICA men. Journal of Addictive Diseases 21, 75–92.CrossRefGoogle Scholar
First, M.B., Williams, J.B., Gibbon, M. & Spitzer, R.L. (1997a). Structured Clinical Interview for DSM-IV AXIS I Disorders, Clinician Version. American Psychiatric Press: Washington.Google Scholar
First, M.B., Williams, J.B. & Spitzer, R.L. (1997b). Structured Clinical Interview for DSM-IV AXIS II Personality Disorders. American Psychiatric Press: Washington.Google Scholar
Gaughwin, M., Solomon, P. & Ali, R. (1998). Correlates of retention on the South Australian Methadone Program 1981-91. Australian and New Zealand Journal of Public Health 22, 771–776.CrossRefGoogle ScholarPubMed
Goldsmith, H.F., Wagenfeld, M.O., Manderscheid, R.W. & Stiles, D.J. (1996). Geographical distribution of organized mental health services in 1983 and 1990. In Mental Health, United States, 1996 (ed. Manderscheid, R.W. and Sonnenschein, M.A.), pp. 154–167, DHHS Publication No. SMA 96-3098. Substance Abuse and Mental Health Services Administration, Center for Mental Health Services: Rockville, MD.Google Scholar
Gonzalez, I., Rosenthal, M.S., Bigler, M.O., Alper, K. & Geringer, W. (1994). HIV antibody testing and client retention in the therapeutic community. A preliminary report of Phoenix House. Journal of Substance Abuse Treatment 11, 481–488.CrossRefGoogle ScholarPubMed
Hoff, R.A., Beam-Goulet, J. & Rosenheck, R.A. (1997). Mental disorder as a risk factor for human immunodeficiency virus infection in a sample of veterans. Journal of Nervous and Mental Disease 185, 556–560.CrossRefGoogle Scholar
Hunt, G.E., Bergen, J. & Bashir, M. (2002). Medication compliance and comorbid substance abuse in schizophrenia: impact on community survival 4 years after a relapse. Schizophrenia Research 54, 253–264.CrossRefGoogle ScholarPubMed
Kelley, J.L. & Petry, N.M. (2000). HIV risk behaviors in male substance abusers with and without antisocial personality disorder. Journal of Substance Abuse Treatment 19, 59–66.CrossRefGoogle ScholarPubMed
Kingree, J.B., Glasford, M.T. & Jones-Allen, M. (1997). A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program. American Journal of Drug and Alcohol Abuse 23, 569–580.CrossRefGoogle Scholar
Margolese, H.C., Malchy, L., Negrete, J.C., Tempier, R. & Gill, K. (2004). Drug and alcohol use among patients with schizophrenia and related psychoses: levels and consequences. Schizophrenia Research 67, 157–166.CrossRefGoogle ScholarPubMed
Meade, C.S. & Sikkema, K.J. (2005). HIV risk behavior among adults with severe mental illness: a systematic review. Clinical Psychology Review 25, 433–457.CrossRefGoogle ScholarPubMed
Nuttbrock, L.A., Rahav, M., Rivera, J.J., Ng-Mak, D.S. & Link, B.G. (1998). Outcomes of homeless mentally ill chemical abusers in community residences and a therapeutic community. Psychiatric Services 49, 68–76.CrossRefGoogle Scholar
Pani, P.P., Trogu, E., Contu, P., Agus, A. & Gessa, G.L. (1997). Psychiatric severity and treatment response in a comprehensive methadone maintenance treatment program. Drug and Alcohol Dependence 48, 119–126.CrossRefGoogle Scholar
Sacks, S., Sacks, J.Y. & De Leon, G. (1999). Treatment for MICAs: design and implementation of the modified TC. Journal of Psychoactive Drugs 31, 19–30.CrossRefGoogle ScholarPubMed
Schilling, R.F., El-Bassel, N., Schinke, S.P., Gordon, K. & Nichols, S. (1991). Building skills of recovering women drug users to reduce heterosexual AIDS transmission. Public Health Reports 106, 297–304.Google ScholarPubMed
Schlesinger, M. & Dorwart, R.A. (1992). Falling between the cracks: Failing national strategies for the treatment of substance abuse. Daedalus 121, 195–237.Google Scholar
Sikkema, K.J., Meade, C.S., Doughty-Berry, J.D., Zimmerman, S.O., Kloos, B. & Snow, D.L. (2007). Community-level HIV prevention for persons with severe mental illness living in supportive housing programs: a pilot intervention study. Journal of Prevention & Intervention in the Community 33, 121–135.CrossRefGoogle ScholarPubMed
Stata Corporation. (2003). Stata Statistical Software: Release 8.0. Stata Corporation: College Station, TX.Google Scholar
Weiser, S.D., Wolfe, W.R. & Bangsberg, D.R. (2004). The HIV epidemic among individuals with mental illness in the United States. Current HIV/AIDS Reports 1, 186–192.CrossRefGoogle Scholar
Winett, R.A., Anderson, E.S., Desiderato, L.L., Solomon, L.J., Perry, M., Kelly, J.A., Sikkema, K.J., Roffman, R.A., Norman, A.D., Lombard, D.N. & Lombard, T.N. (1995). Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework. Applied and Preventive Psychology 4, 233–245.CrossRefGoogle Scholar
Zisook, S., Peterkin, J., Goggin, K.J., Sledge, P., Atkinson, J.H. & Grant, I. (1998). Treatment of major depression in HIV-seropositive men. HIV Neurobehavioral Research Center Group. Journal of Clinical Psychiatry 59, 217–224.Google ScholarPubMed