This study examined the prevalence of lifetime traumatic events and current symptoms posttraumatic stress disorder (PTSD) among treatment-seeking cocaine-dependent outpatients compared patients with without PTSD on substance use, psychopathology, sociodemographic characteristics.The subjects were 122 adult participating in a treatment outcome psychosocial therapy. In addition to standard self-report interview measures psychopathology completed Trauma History Questionnaire Checklist before...

Abstract Many HIV-positive individuals face multiple barriers to care and therefore frequently experience unmet medical support services needs. Rural areas often lack the infrastructure delivery of comprehensive HIV services; however, few studies have examined service faced by rural residents with HIV/AIDS, particularly in South where two-thirds people living HIV/AIDS reside. We surveyed North Carolina case managers (N=111) employed at state-certified agencies regarding that influence...

We examine epidemiological and demographic data documenting the HIV/AIDS epidemic in Deep South region of United States. These document substantial increases AIDS cases from 2000 to 2003. In contrast, other US regions are experiencing stable rates or small new cases. Furthermore, is more concentrated than among African Americans, women, rural residents. The also has some highest levels poverty uninsured individuals, factors that complicate prevention treatment HIV infection. Further research...

A group of nine states in the Southern United States, hereafter referred to as targeted states, has experienced particularly high HIV diagnosis and case fatality rates. To provide additional information about burden this region, we used CDC surveillance data examine characteristics individuals diagnosed with (2011), 5-year AIDS survival, deaths among persons living (2010). We multivariable analyses explore influence residing at on after adjustment for demographics transmission risk. In 2011,...

Objective: To examine the influence of incident stressful experiences on antiretroviral medication adherence and treatment outcomes. Past trauma history predicts poorer health Human immunodeficiency virus (HIV)-infected individuals experience frequently traumatic events, such as sexual physical assault, housing instability, major financial, employment, legal difficulties. Methods: We measured prospectively adherence, viral load over 27 months in an eight-site, five-state study. Using...

The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward greater proportion of new cases women, African-Americans, and through heterosexual transmission.Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics five southeastern states 2001 to 2002.Sixty four percent African-American, 31% female, 43% acquired HIV sex; 25% had private health insurance. Eighty-one on antiretroviral therapy, 46% RNA viral loads (VL) <400. Women...

Objective: Traumatic life histories are highly prevalent in people living with HIV/AIDS and predict sexual risk behaviors, medication adherence, all-cause mortality. Yet the causal pathways explaining these relationships remain poorly understood. We sought to quantify association of trauma negative behavioral health outcomes assess whether those associations were explained by mediation through psychosocial characteristics. Methods: In 611 outpatient HIV/AIDS, we tested trauma's influence on...

Abstract A history of traumatic and/or stressful experiences is prevalent among HIV-infected individuals and has been consistently associated with poorer health outcomes. However, little known about incident the factors that predict these individuals. Data from a longitudinal study 611 in Southeastern USA were used to examine frequency types stress reported 27-month period determine predictors three measures (all events, severe events such as physical assault). Incident frequently occurred...

Mental illness and substance abuse have been consistently associated with poor HIV-medication adherence other negative health outcomes.A brief mental use screening instrument was administered to 1,362 HIV-infected individuals receiving care at two academic medical center Infectious Diseases Clinics in North Carolina.Study results indicated high frequencies of symptoms (60%), (32%), co-occurring (23%). Younger age (P = 0.03), male sex < 0.001), higher viral load 0.001) were problems. White...

Abstract Providing behavioral treatment for mental health and substance use disorders among HIV-infected individuals is critical because these have been associated with negative outcomes such as poorer medication adherence. This study examines the effectiveness of an integrated model who both disorders. Study participants (n = 141) were recruited through routine abuse screening at tertiary Infectious Disease clinics in North Carolina. The received one year interviewed three-month intervals....

Long travel times have been identified as a significant barrier to accessing mental health and other critical services. This study examines whether distance treatment was receiving outpatient substance abuse care for HIV-positive persons when transportation provided. Data from cohort of who participated in year-long programme were examined longitudinally. Transportation, which included buses, taxis, mileage reimbursement private transportation, provided free charge participants needed this...

Mental illness and substance abuse are common among HIV-infected individuals associated with negative outcomes, including poor medication adherence. Therefore, quick effective methods for detecting these co-occurring disorders necessary health care practitioners. This article reports on the creation preliminary testing of a brief screening tool, Substance Abuse Illness Symptoms Screener (SAMISS). The 13-item screener was developed primarily from existing scales administered to receiving at...

Abstract Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about rural-living individuals. This article examines use by adults the Southern U.S., where approximately two-thirds rural HIV cases reside, and compares between those areas. Data were obtained from surveys receiving care at tertiary Infectious Diseases clinics U.S. (n = 474). Study findings indicated that participants living areas with a...

Abstract: The purpose of this case study was to ascertain the perceptions health professionals who were located in six rural communities where hospital closure occurred, regarding impact on community residents. These asked respond questions about effects closures availability medical services such as emergency care, physician services, and nursing home care. To control for trends utilization that unrelated closure, design included comparison areas similar hospitals remained open. A...

The challenge of providing effective treatment services for the growing population HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV prevention. This article describes a model that was created study integrated disorders. based on transtheoretical behavior change well evidence-based practices widely used in involved collaboration between medical behavioral...

Objective: The Addiction Severity Index (ASI) includes items to assess patients' history of trauma (physical or sexual). goal this study was the sensitivity and specificity those questions in relation Trauma History Questionnaire (THQ), a more thorough measure lifetime and, addition, an actual posttraumatic stress disorder (PTSD) diagnosis. Method: At start treatment cocaine dependent outpatients (N = 110, 65.5% male) were assessed on ASI, THQ PTSD symptom checklist as part multisite...

Unmet needs for services, such as housing and psychiatric treatment, are relatively common among HIV-infected individuals; however, the effects of different types unmet on health-care outcomes not well understood. This study describes psychosocial their relationship with individuals receiving HIV care in southeastern US (n=526). We used multivariate logistic regression to examine association seven categories medication use adherence. Most participants (84.5%) reported at least one service...

Women and minorities continue to account for a higher proportion of AIDS incidence mortality than their male white counterparts. This study examined whether race gender were associated with antiretroviral use among HIV-infected individuals in the southeastern US.Multivariate regression analyses used identify predicted protease inhibitor (PI) or non-nucleoside reverse transcriptase (NNRTI) from 1996 2000 receiving HIV primary care.Female nonwhite significantly lower likelihood being...