Use of psychotropic medications among HIV-infected patients in the United States

Author: Vitiello, Benedetto; Burnam, M. Audrey; Bing, Eric G.; Beckman, Robin; Shapiro, Martin F.

Description: OBJECTIVE: This study describes the prevalence and pattern of use of psychotropic medications by HIV-positive patients receiving medical care in the United States and the search for possible predictors of use.

METHOD: The HIV Cost and Services Utilization Study database was analyzed. From the estimated 231,400 HIV-positive patients in medical care in the contiguous United States, a probability sample of 2,864 adults who had paid at least one visit to their medical provider in early 1996 was selected. A representative group of 1,561 received the long form of the Composite International Diagnostic Interview and a questionnaire on psychotropic medications used during the previous 6 months; 1,489 patients (95.4%) completed the assessments.

RESULTS: An estimated 27.2% of HIV-positive patients took psychotropic medications in 1996. Antidepressants were the most commonly prescribed drug class (20.9% of patients), followed by anxiolytics (16.7%), antipsychotics (4.7%), and psychostimulants (3.0%). Among patients with major depression or dysthymia, 43.2% reported receiving antidepressants, and 34.3% reported receiving anxiolytics. Psychiatric comorbidity was associated with greater use of psychotropics. Use of psychotropics in general, and antidepressants in particular, was significantly lower among African Americans than whites or Hispanics. Among patients with mood disorders, 61.0% of whites, 51.4% of African Americans, and 66.7% of Hispanics reported use of antidepressant medications or some type of psychosocial intervention.

CONCLUSIONS: Psychotropics were commonly used by HIV-positive patients in medical care. About half of the patients suffering from depressive disorders did not receive antidepressants. Psychotropic drug use was lower among African Americans than other ethnic groups.

Subject headings: Adolescent; Adult; Black or African American; Anti-Anxiety Agents; Antidepressive Agents; Anxiety Disorders; Comorbidity; Delivery of Health Care; Depressive Disorder; Drug Utilization; Female; HIV Infections; Health Care Surveys; Humans; Insurance Coverage; Male; Medicare; Mental Disorders; Middle Aged; Practice Patterns; Physicians; Psychotropic Drugs; United States

Publication year: 2003

Journal or book title: The American Journal of Psychiatry

Volume: 160

Issue: 3

Pages: 547-554

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Serial number: 3730

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