The effects of psychological functioning on substance use and treatment outcomes among people with HIV

The interrelatedness of mental health status and HIV-related outcomes is well-documented. However, the long-term relationship between psychological distress and health outcomes among persons with HIV, co-diagnosed with substance use disorders (SUD), is understudied. We measured psychological distress among men and women with HIV who use drugs, using a low-burden instrument, and tested its effect, longitudinally, on HIV and substance use-related outcomes. Recently hospitalized, adult men and women co-diagnosed with HIV and SUD were surveyed for psychological distress, using the 18-item Brief Symptom Inventory (BSI-18). We tested the short-term (6 months) and long-term (12 months) effect of psychological distress on HIV-related and substance use-related outcomes. Psychological distress predicted higher engagement with SUD treatment and higher substance use, which decreased rapidly, and significantly, over time. No significant relationship was found between psychological distress and HIV viral load suppression. Using brief and easy to administer measures, early detection of psychological distress among persons with HIV and SUD, could avert negative, long-term health consequences-warranting further investigation of interventions that address mental health challenges faced by this population.