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APHA Scientific Session and Event Listing

Recorded presentation

Michael B. Blank, PhD and Aileen Rothbard, ScD. Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Room 3020, Philadelphia, PA 19104, 215-349-8488, mblank2@mail.med.upenn.edu

Objective: To establish estimates of the relative risk of receiving treatment for an opportunistic infection in a Medicaid population over an eleven-year period, to contrast rates among persons with mental illnesses with others, and to examine rates of AIDS-defining infections with more commonly occurring infections.

Methods: Subjects were adult Medicaid recipients who received a diagnosis of severe mental illness and/or HIV/AIDS between July, 1986 and June,1997. Medicaid claims records were used both to identify diagnostic groups and to identify denominators of individuals who received treatment for one or more of the target conditions during the study period. Opportunistic infections were classified according whether or not they were AIDS-defining infections or more commonly occurring infections also found in the general population.

Results: For commonly occurring opportunistic infections, persons with co-morbid SMI and HIV/AIDS had the highest relative risk, followed by persons who were HIV positive only. Persons with SMI-only were at greater risk than the general Medicaid population. Interestingly, the SMI-HIV+ group had higher rates of AIDS-defining OI's including Pneumocystosis, Micobacteriosis, Cryptococcosis, Cytomegalovirus, and Toxoplasmosis.

Conclusions: Health care provides should be aware of the increased risk for adverse health outcomes for persons with co-morbid HIV/AIDS and SMI. Potential reasons for why AIDS-defining infection rates are lower among persons with mental illnesses will be discussed.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe why opportunistic infections occur more frequently in persons with mental illnesses.
• Articulate the types of infections that occur more frequently in the general HIV positive population.
• Develop a care plan for ongoing treatment of persons with syndemic HIV and Mental Illness.

Keywords: HIV/AIDS, Mental Illness

Related Web page: www.uphs.upenn.edu/cmhpsr/

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation