Health Care Consumption, Psychiatric Diagnoses, and Pharmacotherapy 1 and 2 Years Before and After Newly Diagnosed HIV: A Case-Control Study Nested in The Greater Stockholm HIV Cohort Study

Abstract

Objective: We compare individuals with newly diagnosed HIV with sex-, age-, and socioeconomic status-matched HIV-negative controls, with the aim of studying the frequency of health care visits, the types of clinics visited, registered diagnoses, and psychopharmacotherapy. Methods: The data were collected through the Stockholm Region administrative database (Stockholm Regional Health Care Data Warehouse) for men and women (people) living with newly diagnosed HIV (PLWH) in their medical records (930 men, 450 women) and controls. The odds ratios (ORs) with 99% confidence intervals (CIs) for psychiatric comorbidities and relevant pharmacotherapies were calculated during the 2011-2018 period. Results: Substance use disorder was higher in PLWH than in controls, before and after newly diagnosed HIV in men (OR = 1 year before 4.36 [99% CI = 2.00-9.5] and OR = 1 year after 5.16 [99% CI = 2.65-10.08]) and women (OR = 1 year before 6.05 [99% CI = 1.89-19.40] and OR = 1 year after 5.24 [99% CI = 1.69-16.32]). Health care contacts and psychiatric disorders were more common in cases than controls 1 and 2 years after diagnosis, particularly for depression in men 1 year after HIV (OR = 3.14, 99% CI = 2.11-4.67), which was not found in women (1 year OR = 0.94, 99% CI = 0.50-1.77). Conclusions: Before newly diagnosed HIV, PLWH have the same level of psychiatric diagnoses as their controls, except for substance use disorder. Psychiatric problems are more common in PLWH than in their controls after newly diagnosed HIV.

HIV associated psychiatric comorbidity among attendees at a tertiary hospital, North-Eastern Nigeria

“… 3 This increased risk of contracting HIV has been reported among individuals with substance use disorder, 9 while Wandel et al showed that the prevalence of substance use disorders was high in HIV positive persons even before the diagnosis of HIV. 10 Risky behaviour can also occur in those who are disinhibited in certain affective disorders like mania. 11 On the other hand, having a chronic illness, such as HIV, can predispose to mental health disorders both from the development of AIDS and HIV-associated neurocognitive disorder (HAND) 10 as well as from various psychological and social processes such as stigma.…”

“… 10 Risky behaviour can also occur in those who are disinhibited in certain affective disorders like mania. 11 On the other hand, having a chronic illness, such as HIV, can predispose to mental health disorders both from the development of AIDS and HIV-associated neurocognitive disorder (HAND) 10 as well as from various psychological and social processes such as stigma. 12 In addition, antiretrovirals, 13 viral load 1 and decrease in functioning 1 can predispose to psychiatric morbidity.…”

The Interaction of HIV With Mental Health in the Modern Antiretroviral Therapy Era

“…Substance use disorders are also prevalent comorbidities that increase the risk of HIV acquisition and potentiate faster clinical HIV progression (29,30). Findings reported by Wändell et al (31) from the Greater Stockholm Cohort Study revealed that substance use disorders were elevated in PWH before the diagnosis of HIV. In addition, the elevated prevalence of substance use disorders persisted in the year after HIV diagnosis, which reflects the chronic and often relapsing nature of problematic substance use.…”