HIV/AIDS Program: Center for Mental Health Services Substance Abuse and Mental Health Services Administration

January 19, 2006

The American Psychological Association (APA) urges Congress to reject the proposed cut in the President's budget for the HIV/AIDS program and provide the Center for Mental Health Services (CMHS) with an additional $1 million for programs aimed at providing culturally competent and accessible mental health services for people of color living with HIV/AIDS.

Background

Racial and ethnic minorities are disproportionately affected by HIV/AIDS. Approximately 40,000 people are newly infected with HIV each year. Although African Americans represent only 13% of the U.S. population, they account for 40% of the AIDS cases diagnosed since the start of the epidemic and approximately half of the cases diagnosed in 2003 alone. The AIDS case rate among African Americans and Latino/as is 10.4 and 3.7 times that of whites, respectively.

More women of color are becoming infected with HIV/AIDS. W omen diagnosed with AIDS have grown from 8% in 1985 to 27% in 2003. African American and Latinas represent more than three-fourths of AIDS cases among women.

Many people living with HIV/AIDS suffer from a mental disorder. About half of persons with HIV have a mental disorder, and about 40 percent use illicit drugs. According to the HIV Cost and Services Utilization Study , 62% of people living with AIDS have a depressive disorder and 16% have a generalized anxiety disorder. Racial and ethnic minorities, by virtue of lower socioeconomic status, are disproportionately affected by mental illness.

Persons with mental disorders frequently have difficultly managing their HIV. They tend to be less compliant with medication regimens and medical appointments, which can lead to emergence and potential transmission of drug-resistant HIV. According to a 2004 Institute of Medicine report ( Public Financing and Delivery of HIV/AIDS Care: Securing the Legacy of Ryan White ), mental health treatment can help stabilize the health and well-being of individuals with HIV and potentially contribute to better adherence to antiretroviral drug treatment.

Mental health and substance abuse treatment is under-utilized among persons with HIV/AIDS. Among the HIV-positive population, about half receives substance use treatment, and only one-third receives mental health care. People of color living with HIV/AIDS have less access to and lower utilization of mental health and substance abuse services than whites with HIV/AIDS. Racial and ethnic minorities face greater barriers to mental health services, including t he lack of culturally- and language-appropriate services and mistrust of mental health providers. Research has documented an underrepresentation of bilingual providers of mental health services.

Recommendations

The American Psychological Association urges Congress to continue its support for HIV/AIDS programs targeting racial and ethnic minorities at the CMHS by increasing funding by $1 million, to $10 million, for FY 2006.