IMPROVING HIV TREATMENT FOR THE SERIOUSLY MENTALLY ILL

描述（申请人摘要）：患有严重精神疾病的人 (SMI)已被证明是在艾滋病毒感染的风险增加，但很少 对SMI艾滋病毒阳性者的了解，几乎对艾滋病毒一无所知。 他们所关心的（或不关心的）。 这项为期4年的研究的主要目标是 是让人们了解这个群体以及当前的系统 护理的目的是满足他们的需求，以便改善护理。 是什么 了解这一人口和过度拥挤，资金不足的系统收费 与他们的照顾表明，SMI的人很可能被诊断为在 艾滋病毒感染的后期阶段，并有更陡峭的疾病过程， 更短的生存时间。 这项研究将利用数据和方法 根据艾滋病毒成本和服务利用研究（HCSUS）， 一项全国代表性的3300人样本的纵向研究， 艾滋病毒呈阳性，并为艾滋病毒提供者所知。 随机抽取700名SMI 将对美国8个研究中心的HIV阳性成人进行研究，并与非SMI进行比较 HCSUS中的艾滋病毒阳性参与者。 具体目标是：描述 人口统计学、临床和一般健康特征 700名艾滋病毒阳性成年人;确定他们的利用模式， 费用，以评估获得护理和护理质量;比较 开始接受护理时的艾滋病毒疾病阶段和18个月存活率 与非SMI艾滋病毒阳性者;并评估组织，财务， 以及与政策有关的障碍，使他们无法得到适当的照顾。 这些目标 将通过收集和分析定量数据 （面对面访谈）以评估人口统计学、精神病诊断、艾滋病毒 服务的状况、获得和利用情况， 生活、艾滋病服务满意度、艾滋病知识和危险行为; 医疗和账单记录摘要;以及18个月生存信息 和定性数据（案例研究，焦点小组， 参与者-观察）在所有8个地点。

DESCRIPTION (Applicant's Abstract): People with serious mental illness (SMI) have been shown to be at elevated risk for HIV infection, yet little is known about SMI HIV-positive persons, and virtually nothing about the HIV care they are (or are not) receiving. The broad goal of this 4-year study is to provide an understanding of this population and how the current system of care is responding to their needs so that care may be improved. What is known about this population and the overcrowded, underfunded systems charged with their care suggests that SMI persons are likely to be diagnosed at later stages of HIV infection, and have more precipitous illness courses and shorter survival times. This study will make use of data and methodology from the HIV Cost and Services Utilization Study (HCSUS), a large longitudinal study of a nationally representative sample of 3300 persons who are HIV-positive and are known to HIV providers. A random sample of 700 SMI HIV-positive adults in 8 U.S. sites will be studied and compared to non-SMI HIV-positive participants in HCSUS. The specific aims are: to describe the demographics, clinical and general health characteristics of this sample of 700 SMI HIV-positive adults; to determine their patterns of utilization and costs in order to evaluate access to care and quality of care; to compare their stage of HIV disease at entry into care and 18-month survival rates with non-SMI HIV-positive persons; and to assess organizational, financial and policy-related barriers to their receiving appropriate care. These aims will be achieved by collecting and analyzing both quantitative data (face-to-face interviews) to assess demographics, psychiatric diagnoses, HIV status, access to and utilization of services, health-related quality of life, satisfaction with HIV services, and HIV knowledge and risk behaviors; medical and billing record abstractions; and 18-month survival information and qualitative data (case studies, focus groups, and participant-observation) in all 8 sites.