The Association of Mental Health and Substance Use With Retention in HIV Care Among Black Women in Washington, District of Columbia

Authors

Bianca Stewart, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia. Electronic address: biancastewart@gwu.edu.
Morgan Byrne, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
Matthew Levy, Helix, San Mateo, California.
Michael A. Horberg, Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland.
Anne K. Monroe, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
Amanda D. Castel, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.

Document Type

Journal Article

Publication Date

1-5-2024

Journal

Women's health issues : official publication of the Jacobs Institute of Women's Health

DOI

10.1016/j.whi.2023.11.003

Abstract

BACKGROUND: Black women with HIV are impacted by mental health and substance use disorders alongside barriers to care. The impact of these disorders on retention in care, a crucial step of the HIV care continuum, has not been well-studied. We examined the association between these disorders and retention in care over a 2-year period. METHODS: Data from January 1, 2011, to June 30, 2019, were obtained from the DC Cohort, an observational HIV study in Washington, District of Columbia. We examined the associations between mental health (i.e., mood-related or trauma-related) or substance use disorders, separately, on not being retained in HIV care over a 2-year interval post-enrollment among non-Hispanic Black women with HIV. Multivariate logistic regression with adjusted odds ratios (aORs) for sociodemographic and clinical variables was used to quantify the association of 1) having a confirmed mental health or substance use disorder and 2) not being retained in care. RESULTS: Among the 2,181 women in this analysis, 690 (31.64%) were not retained in care. The prevalence of a mood-related disorder (39.84%) was higher compared with a substance use (16.19%) or trauma-related disorder (7.75%). Age per a 10-year increase (aOR 0.87; confidence interval [CI] 0.80, 0.94) and a mood-related disorder diagnosis (aOR 0.72; CI: 0.59, 0.88) were inversely associated with not being retained in care. CONCLUSION: Mood-related disorders were prevalent among Black women with HIV in Washington, District of Columbia, but were not associated with worse retention in care. Future studies should examine key facilitators for Black women with HIV and coexisting mood-related disorders and how they impact retention in care.

APA Citation

Stewart, Bianca; Byrne, Morgan; Levy, Matthew; Horberg, Michael A.; Monroe, Anne K.; and Castel, Amanda D., "The Association of Mental Health and Substance Use With Retention in HIV Care Among Black Women in Washington, District of Columbia" (2024). GW Authored Works. Paper 4207.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4207

Department

Epidemiology