Methods: A Psychiatry and Infectious Diseases collaborative established a nested PSY consultation and assessment process within the outpatient HIV clinic. Two PSY providers participated in the management discussion of pts to determine PSY needs and provide services as desired.
Results: From 7/1/14-5/7/15, PSY providers attended clinic weekly where 199 HIV pts (of an overall cohort of 1095) presented for medical care and participated in the management discussion of 73 (37%). Most were male (67%), AA (60%), >45 yrs old (52%) and had well controlled HIV (64%). 47 (64%) were identified as having a PSY need and 39 (53%) went on to formally engage in PSY care. Of those 39 pts, 54% were evaluated for PSY medical management in the context of complex antiretrovirals and 51% received psychotherapy as well. Psychotherapy included issues of self-acceptance, feelings of isolation within small communities and personal relationship instability as well as cognitive behavioral therapy for specific disorders. Among the 34 pts who did not formally engage in PSY care, 68% had no preexisting PSY disorder and of those who did, they had no acute issue or did not wish to engage in services. There were no differences in age, sex, sexual orientation, or proportion with VL <40 between those who engaged in PSY care and those who didn’t but those who engaged in PSY care were significantly more likely to have a preexisting PSY disorder (100 vs 32% p<0.0001) or substance use (56 vs 18% p=0.0007). Significantly fewer AA were among those formally engaged in PSY care compared to those who weren’t (49 vs 73% p=0.03) but compared to our entire cohort AA were underrepresented in our sample (70 vs 60% p=0.02).
Conclusion: Even among a cohort of well controlled HIV pts in the Deep South there were substantial PSY needs where among those evaluated 53% went on to formally engage in PSY care. Based on this assessment, we plan to expand our collaboration to reach additional pts with focus on pts with preexisting PSY disorders and substance use. AA were underrepresented among those engaged in PSY care but some of this disparity may be explained by having fewer AA in our sample.
E. Kantor, None
C. Salgado, None