Substance Use and its Association with Psychiatric Symptoms in Perinatally HIV-infected and HIV-Affected Adolescents.
Summary of "Substance Use and its Association with Psychiatric Symptoms in Perinatally HIV-infected and HIV-Affected Adolescents."
Drug use in combination with psychiatric illness may lead to unsafe sexual risk behavior and increased risk for secondary HIV transmission among adolescents with HIV infection. We compared the prevalence of substance use for perinatally HIV-infected youth to uninfected adolescents living in families affected by HIV infection, and evaluated the association of psychiatric symptoms with risk of substance use. Among 299 adolescents (196 HIV+, 103 HIV-) aged 12-18 years enrolled in IMPAACT P1055, a multisite US cohort study, 14% reported substance use at enrollment (HIV+: 13%, HIV-: 16%). In adjusted logistic regression models, adolescents had significantly higher odds of substance use if they met symptom criteria for ADHD [adjusted odds ratio (aOR) = 2.7, Wald chi(2) = 5.18, P = 0.02], major depression or dysthymia (aOR = 4.0, Wald chi(2) = 7.36, P = 0.01), oppositional defiant disorder (aOR = 4.8, Wald chi(2) = 12.7, P = 0.001), or conduct disorder (aOR = 15.4, Wald chi(2) = 28.12, P = 0.001). Among HIV-infected youth, those with lower CD4 lymphocyte percentage (CD4% < 25%) had significantly increased risk of substance use (aOR = 2.7, Wald chi(2) = 4.79, P = 0.03). However, there was no overall association of substance use with HIV infection status, and the association between psychiatric symptoms and substance use did not differ by HIV status. Programs to prevent substance use should target both HIV-infected and uninfected adolescents living in families affected by HIV infection, particularly those with psychiatric symptoms.
Affiliation
Center for Biostatistics in AIDS Research, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA, paige@hsph.harvard.edu.
Journal Details
This article was published in the following journal.
Name: AIDS and behavior
ISSN: 1573-3254
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20725774
- DOI: http://dx.doi.org/10.1007/s10461-010-9782-0
Medical and Biotech [MESH] Definitions
Psychophysiologic Disorders
A group of disorders characterized by physical symptoms that are affected by emotional factors and involve a single organ system, usually under AUTONOMIC NERVOUS SYSTEM control. (American Psychiatric Glossary, 1988)
Diagnosis, Dual (psychiatry)
The co-existence of a substance abuse disorder with a psychiatric disorder. The diagnostic principle is based on the fact that it has been found often that chemically dependent patients also have psychiatric problems of various degrees of severity.
Somatoform Disorders
Disorders having the presence of physical symptoms that suggest a general medical condition but that are not fully explained by a general medical condition, by the direct effects of a substance, or by another mental disorder. The symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of functioning. In contrast to FACTITIOUS DISORDERS and MALINGERING, the physical symptoms are not under voluntary control. (APA, DSM-IV)
Alien Hand Syndrome
An apraxia characterized by the affected limb having involuntary, autonomous, and purposeful behaviors that are perceived as being controlled by an external force. Often the affected limb interferes with the actions of the normal limb. Symptoms develop from lesions in the CORPUS CALLOSUM or medial frontal cortex, stroke, infarction, and neurodegenerative diseases (e.g., CREUTZFELDT-JAKOB SYNDROME, corticobasal degeneration).
Psychiatric Somatic Therapies
The biologic treatment of mental disorders (e.g., ELECTROCONVULSIVE THERAPY), in contrast with psychotherapy. (Stone, American Psychiatric Glossary, 1988, p159)
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