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181088 Treated prevalence of HIV/AIDS among Medicaid patients with diagnosed schizophrenia in 110 U.S. cities

Wednesday, October 29, 2008

James Walkup, PhD , Graduate School of Applied and Professional Psychology at Rutgers University, Piscataway, NJ
Ayse Akincigil, PhD , School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ
Shala Amin, MS , Rutgers University, Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
Scott M. Bilder, MS , Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ
Stephen Crystal, PhD , Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ
Background: Research to date indicates HIV rates are elevated among

persons with schizophrenia in a number of settings. Data are needed to

profile geographical variation of this phenomenon, and to document

associations with local HIV context.

Methods: Naturalistic observational study using Medicaid Analytic

Extract (MAX) for 1999-2000 from California, Florida, New Jersey,

Texas, and New York. Cities selected were those >2000 Medicaid

beneficiaries. Diagnostic classification based on ICD-9-CM, one

inpatient or two outpatient claims. Eligibility criteria: Patients

aged 18-64 with claims for SZ (and a minimum of one full year

eligibility, no comprehensive HMO coverage and no long term care days.

Estimates of HIV/AIDS prevalence among injection drug users based on

Friedman, et al. (2005).

Results: In 110 selected cities, the treated HIV prevalence rate among

patients diagnosed with schizophrenia ranged from 0.0% to 8.3%, with a

median of 1.0%. For 34 of these cities, published rates of HIV among

injection drug users were available. Correlation between these rates

was 0.73.

Conclusions: In these administrative data, prior estimates of elevated

HIV among patients with schizophrenia do not provide a reliable guide to

infection rates across multiple geographic locations. The impact of HIV

on people with serious mental illness is likely to vary based on local

epidemic dynamics.

Learning Objectives:
Recognize wide variability in treated prevalence rates among patients with schizophrenia Consider role of local epidemic conditions influencing these prevalence rates

Keywords: HIV/AIDS, Sever Mental Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: involved in conceptualization, interpretation, writingJa
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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