February 19, 2014
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HIV prevalence higher among adults treated for mental illness

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Among patients with serious mental illness, the prevalence of HIV was four times higher than the general population, researchers reported in the American Journal of Public Health.

“These findings paint a recent picture of HIV infection rates in the community and reinforce how important it is to identify patients and get them into appropriate infectious disease care in a timely manner while being treated for mental illness, Michael B. Blank, PhD, associate professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania, said in a press release. “With such a high-risk group, it’s imperative to be routinely testing patients to improve care and reduce transmission to others. Historically, though, HIV testing is often not implemented in mental health care.”

Michael B. Blank, PhD 

Michael B. Blank

Blank and colleagues conducted a cross-sectional study that included 1,061 patients receiving mental health care in Baltimore or Philadelphia. They were receiving care from university-based inpatient psychiatric units (n=287), intensive case-management programs (n=273) or community mental health centers (n=501).

They found that 51 patients (4.8%) were HIV-positive, nearly four times the HIV prevalence in the two cities. According to the different care groups, 17 of patients in the inpatient units, 14 of patients in intensive case-management programs and 20 of patients at community mental health centers were positive for HIV. Seventy-six percent of the patients who tested positive were aware of their HIV status. In a multivariable analysis, black race, homosexual or bisexual identity and hepatitis C coinfection were associated with positive HIV status.

The CDC and the Institute of Medicine recommend routine HIV screening at all clinical settings, including mental health settings, but little progress has been made toward integrating HIV testing into mental health care, Blank said.

“There are barriers to testing, be it funding, system-level barriers or access to rapid HIV testing, that need to be addressed in order to have a wider adoption,” Blank said.

Disclosure: Blank reports no relevant financial disclosures.