The proposed project is will examine the relationship between the level of integration in the care people with HIV and severe mental illness receive and their medical outcomes reflected in outpatient medical records. Patients in two HIV clinics will be recruited, and measures indicating the presence of mental illness, their physical and emotional functioning, and their perceptions of the degree of care integration will be taken. Outpatient records of those participants who are indicated as having a mental illness through the SCL-90R will be abstracted to determine whether or not the HIV provider is aware of their mental illness, if they are providing treatment for the mental illness, and/or if mental health care is being provided by an outside provider, and the degree of integration of HIV and mental health treatment. This level of integration will be examined against the physical and emotional outcomes obtained through the SF-36, and documentation on CD4 and MRNA levels, acute infections and illness, and adherence to medications found in the outpatient record. This project will also explore sources and structures of data for future use in examing data on medical outcomes available through hospitalization records, pharmacy dispensing data, and claims data.
