Effectiveness of HIV-related mental health practice in inner cities has not been adequately documented despite an urgent need for interventions for populations disproportionately affected by the epidemic. Practices must take into account and respond to cultural issues of people of colour and the needs of those infected through injection drug use or heterosexual sex with IDUs. We report the effectiveness of an HIV mental health programme integrated with primary care and emphasizing cultural responsiveness. A sample of 47 of 188 patients who received psychiatric and psychotherapy services was compared with other subjects. The 47 had an average of 8.34 encounters over an average of 36.23 weeks. Consumers of project services used mental health care at a higher rate than did comparison subjects. Regression analyses indicated that utilization was related to reduction in reported mental health problems, HIV-related physical symptoms, and use of alcohol and powdered cocaine, as well as to improvement in social functioning. Our clients, individuals often viewed as not likely to avail themselves of or benefit from mental health care, were highly motivated for self-improvement and, given access to competent, convenient and culturally respectful services, improved their well-being in significant domains.

Executive functions (EF) reached full maturity during the transition from adolescence to adulthood. Human studies provide important information about adolescent developmental trajectories; however, little remains known about the neural circuits underlying the acquisition of mature EF. Ethical and technical considerations with human subjects limit opportunities to design experimental studies that allows for an in-depth understanding of developmental changes in neural circuits that regulate cognitive maturation. Preclinical models can offer solutions to this problem. Unfortunately, current rodent models of adolescent development have inherent flaws that limit their translational value. For instance, females are often omitted from studies, preventing the assessment of potential sex-specific developmental trajectories. Furthermore, it remains unclear whether cognitive developmental changes in rodents are similar to those observed in humans. Here, we tested adolescent and adult male and female mice in a neurocognitive battery of assays. Based on this approach, we assessed mice performances within distinct subdomains of EF, and observed similarities with human developmental trajectories. Furthermore, the sex-specific cognitive changes we observed were paralleled by molecular and neural activity changes demonstrating that our approach can be used in future research to assess the contribution of precise neural circuits to adolescent cognitive maturation.

We identify the psychiatric diagnoses and utilization patterns of HIV-positive persons of color who received culturally responsive mental health services integrated into a community medical clinic. Ninety-three patients were referred and 86% (n = 80) appeared for at least one encounter. Hispanics, compared with African-Americans, and HIV patients, compared with AIDS patients, were more likely to receive psychotropic prescriptions. Patients with six or more visits were defined as high utilizers: they comprised 27.5% of the patients but used 67.3% of the services. Development of a broader range of psychiatric interventions that address diagnoses, utilization, and psychotropics will better meet these patients' needs.

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