Outcomes of an inner-city HIV mental health programme integrated with primary care and emphasizing cultural responsiveness.

Effectiveness of HIV-related mental health practice in inner cities has not been adequately documented despite an urgent need for interventions for populations disproportionately affected by the epidemic. Practices must take into account and respond to cultural issues of people of colour and the needs of those infected through injection drug use or heterosexual sex with IDUs. We report the effectiveness of an HIV mental health programme integrated with primary care and emphasizing cultural responsiveness. A sample of 47 of 188 patients who received psychiatric and psychotherapy services was compared with other subjects. The 47 had an average of 8.34 encounters over an average of 36.23 weeks. Consumers of project services used mental health care at a higher rate than did comparison subjects. Regression analyses indicated that utilization was related to reduction in reported mental health problems, HIV-related physical symptoms, and use of alcohol and powdered cocaine, as well as to improvement in social functioning. Our clients, individuals often viewed as not likely to avail themselves of or benefit from mental health care, were highly motivated for self-improvement and, given access to competent, convenient and culturally respectful services, improved their well-being in significant domains.