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Among people with HIV/AIDS, whites are much more likely than blacks to use medication to treat psychological problems

In 1996, 29 percent of people with HIV disease suffered from at least one psychological disorder such as depression, anxiety or panic disorder, or posttraumatic stress disorder (PTSD). About 27 percent of all HIV-positive patients in medical care in the United States in 1996 received at least one psychotropic drug, such as antidepressants and anxiolytics (anti-anxiety drugs) in the 6 months preceding assessment.

Use of antidepressants was most common (21 percent of patients), followed by anxiolytics (17 percent), antipsychotics (5 percent), and psychostimulants (3 percent). About 43 percent of patients reporting major depression or dysthymia (depressed mood for more than 2 years, but not severe enough to be considered major depression) reported receiving antidepressants, and 34 percent reported receiving anxiolytics.

Patients with both major depression and dysthymia were more likely to have taken antidepressants (72 percent) than patients with only major depression or dysthymia (41 and 38 percent, respectively). The presence of more than one anxiety disorder increased the rate of anxiolytic use but not antidepressant use.

More than half of the patients suffering from major depression were not treated with antidepressants. On the other hand, 17 percent of those without a diagnosed disorder received psychotropic medication.

Overall psychotropic use among HIV/AIDS patients was 27 percent for whites, 23 percent for Hispanics, and 11 percent for blacks. There was no significant difference in use of psychotropic drugs among patients with asymptomatic HIV infection, symptomatic HIV infection, or AIDS.

These findings are based on an analysis of data from the HIV Cost and Services Utilization Study (HCSUS), which was conducted under a cooperative agreement between RAND and the Agency for Healthcare Research and Quality (HS08578). HCSUS was led by Martin F. Shapiro, M.D., Ph.D., of RAND, and Samuel A. Bozzette, M.D., of the University of California, San Diego. HCSUS included data on 2,864 HIV-positive patients in medical care in the United States. This study was based on 1,489 patients who completed an interview form and questionnaire on psychotropic medications used during the previous 6 months. The majority of these patients had previously screened positive for depression or anxiety disorder.

See "Use of psychotropic medications among HIV-infected patients in the United States," by Benedetto Vitiello, M.D., M. Audrey Burnam, Ph.D, Eric G. Bing, M.D., Ph.D., M.P.H., and others, in the March 2003 American Journal of Psychiatry 160, pp. 547-554.

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