Original ArticlePsychiatric Diagnosis and Antiretroviral Adherence Among Adolescent Medicaid Beneficiaries Diagnosed With Human Immunodeficiency Virus/Acquired Immunodeficiency SyndromeWalkup, James PhD*†; Akincigil, Ayse PhD*‡; Bilder, Scott MS*; Rosato, Nancy Scotto PhD*; Crystal, Stephen PhD*‡ Author Information *Department of Clinical Psychology, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey; †Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey; and ‡School of Social Work, Rutgers University, New Brunswick, New Jersey. Supported by the National Institute of Mental Health (R01 MH076206 and R01 MH058984) and by the Agency for Healthcare Research and Quality (AHRQ) through a cooperative agreement for the Center for Research and Education on Mental Health Therapeutics at Rutgers (U18HS016097), as part of AHRQ's Centers for Education and Research on Therapeutics Program. The content is solely the responsibility of the authors and does not necessarily reflect the official views of NIMH or AHRQ. Send reprint requests to James Walkup, PhD, 30 College Ave., New Brunswick, New Jersey. Email: [email protected]. The Journal of Nervous and Mental Disease: May 2009 - Volume 197 - Issue 5 - p 354-361 doi: 10.1097/NMD.0b013e3181a208af Buy Metrics Abstract Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has suggested that psychiatric and substance abuse comorbidities are prevalent in this population, and that these may sometimes be associated with use of antiretroviral therapy (ART) and adherence. For adolescents with HIV/AIDS, much less is known about patterns of mental health comorbidity, and even fewer data are available that compare them to socioeconomically comparable youth without HIV/AIDS. Using medical and pharmacy data from 1999 to 2000 Medicaid claims (Medicaid Analytic Extract) from 4 states for beneficiaries aged 12 to 17 years, we identified 833 youth under care for HIV/AIDS meeting study criteria within the HIV/AIDS group, receipt of ART was less likely for youth who had diagnoses of substance abuse, conduct disorders, or emotional disorders than for others. Once ART was initiated, adherence did not significantly differ between adolescents living with a psychiatric condition, and those who were not, with the exception of an association between conduct disorder and lower adherence. Among those with HIV/AIDS, ART use and adherence were more common among youth with higher rates of service use, regardless of psychiatric status. Associations between race and adherence varied by gender: compared with their white counterparts, minority girls had lower, and minority boys had higher adherence. © 2009 Lippincott Williams & Wilkins, Inc.