Screening and Assessing Violence and Mental Health Disorders in a Cohort of Inner City HIV-Positive Youth between 1998–2006

The focus of the primary care appointments for HIV-positive youth is often solely on medical concerns. However, these youth also present with mental health issues and histories of exposure to violence. To screen and assess for mental health disorders, HIV-positive youth between the ages of 13 to 24 consecutively enrolled in an adolescent and young adult HIV clinic between 1998-2006 (n = 174), were screened for mental health disorders and violence, using the Client Diagnostic Questionnaire (CDQ). All youth subsequently had diagnostic interviews conducted by psychologists. Findings of the CDQ and the psychological interviews revealed the following. Violence reported by youth occurred in several forms: physical assault/abuse (24% in childhood; 19% as adolescents), sexual abuse/assault (28% in childhood; 15% as adolescents), dating violence (i.e., physical abuse by sexual partner) (18%), and family violence (44%). Females had higher sexual abuse (p < .001). Psychological disorders included: major depressive disorders (15%), generalized anxiety disorder (17%); posttraumatic stress disorder (28%); alcohol abuse disorder (19%); and substance abuse disorder (31%). Physically abused youth had higher symptoms of anxiety (p < 0.05, and PTSD (p < 0.01). Sexually abused youth had higher symptoms of PTSD (p < 0.05). Youth with family violence had higher symptoms of Anxiety Disorder (p < 0.05) and PTSD (p < 0.01). CDQ findings closely correlated with diagnostic assessments of the psychological interview. We conclude that inner city HIV-positive youth present with high prevalence of violence and with psychological disorders. Failure to screen for and treat these psychological disorders may impact successful treatment of their HIV infection.