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Prevalence, Comorbidity, and Correlates of Psychiatric and Substance Use Disorders and Associations with HIV Risk Behaviors in a Multisite Cohort of Women Living with HIV
Open accessAbstract
We used the World Health Organization's Composite International Diagnostic Interview to determine the prevalence, comorbidity, and correlates of lifetime and 12-month behavioral health disorders in a multisite cohort of 1027 women living with HIV in the United States. Most (82.6%) had one or more lifetime disorders including 34.2% with mood disorders, 61.6% with anxiety disorders, and 58.3% with substance use disorders. Over half (53.9%) had at least one 12-month disorder, including 22.1% with mood disorders, 45.4% with anxiety disorders, and 11.1% with substance use disorders. Behavioral health disorder onset preceded HIV diagnosis by an average of 19 years. In multivariable models, likelihood of disorders was associated with women's race/ethnicity, employment status, and income. Women with 12-month behavioral health disorders were significantly more likely than their counterparts to engage in subsequent sexual and substance use HIV risk behaviors. We discuss the complex physical and behavioral health needs of women living with HIV.
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“Indeed, up to 63% of PWH meet criteria for a co-occurring substance use and psychiatric disorder [22, 23], with depression and anxiety being the most common psychiatric co-morbidities [23, 24].”
From A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels. (2026) · cites this paper as [23]
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“Another study examined electronic medical records of HIV-positive patients in California, including 738 women, in which psychiatric disorder and substance use disorder diagnoses were based on clinician judgment and patient self-report [22].”
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“High rates of co-occurring psychiatric disorders and substance use disorders are reported among people living with HIV [10, 16, 17].”
BackgroundPsychopathology and transmission risk behaviors in patients with HIV/AIDS
Newville, H., & Haller, D. L. (2010) · AIDS Care · doi:10.1080/09540121003615111 · Cited by 17
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“Moreover, while awareness of one’s HIV positive serostatus appears to decrease the likelihood of engaging in risk behaviors [41] even among those with psychiatric and/or substance use disorders [42], a noteworthy proportion of individuals living with HIV continue to engage in high-risk sex and drug use behaviors [43],…”
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Metadata
- Authors
- Cook, J. A., Burke-Miller, J. K., Steigman, P. J., Schwartz, R. M., Hessol, N. A., Milam, J., Merenstein, D. J., Anastos, K., Golub, E. T., & Cohen, M. H.
- Affiliations
- University of Illinois Chicago (US)
- Northwell Health (US)
- University of California, San Francisco (US)
- University of Southern California (US)
- Georgetown University (US)
- Albert Einstein College of Medicine (US)
- Johns Hopkins University (US)
- John H. Stroger, Jr. Hospital of Cook County (US)
- ORCID
- Venue
- AIDS and Behavior
- Published
- 2018-02-19
- Volume
- 22
- Issue
- 10
- Pages
- 3141-3154
- ISSN
- 1090-7165 (ISSN-L)
- 1573-3254
- PMC
- PMC6153984
- OpenAlex
- W2791638408
- Cited by
- 102
- References
- 79
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 16 · 2023: 20 · 2022: 20 · 2021: 14 · 2020: 5 · 2019: 11
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- AIDS and Behavior (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (1R01MH089830)
- National Institute of Allergy and Infectious Diseases (U01-AI-035004, U01-AI-034993, U01-AI-042590)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Keywords
- women living with HIV, mental illness, substance use disorders, mood disorders, anxiety disorders, comorbidities, HIV risk behavior, sexual risk behavior, substance use, behavioral health needs, race and ethnicity, employment status, income
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Mental Disorders, Female, Humans, Male, Middle Aged, Risk-Taking, Sexual Behavior, United States, Cohort Studies, HIV Infections, Comorbidity, Prevalence, Mood Disorders, Substance-Related Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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