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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Michael B Blank, PhD, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market Street, Room 3020, Philadelphia, PA 19104, 215-349-8488, mblank@cmhpsr.upenn.edu
This paper presents the evidence-base for integration of HIV prevention into ongoing case management for persons with serious mental illness (SMI). Medicaid claims alone indicated the prevalence of HIV in the general population was .3%, .8% for schizophrenia and 1.7% for affective disorder, for a total risk among the SMI of 1.6%. By crossing claims with surveillance data, prevalence in the general population increased from .3% to .9%, from .8% to 2.8% among people with schizophrenia, and from 1.7% to 4.6% for affective disorders. The total risk for HIV infection among the SMI more than doubled (1.6% - 3.7%). After controlling for sex, age, race, and time on welfare, the odds of an HIV diagnosis given schizophrenia was 2.13 and 4.68 for affective disorders. Significant differences in mode of transmission were found for schizophrenia and affective disorders. There was increased IDU (injection drug use) among those with affective disorders and both IDU and sex with MSM (men who have sex with men) for those with schizophrenia. 1996 Inpatient and outpatient costs for those with co-morbid illness (>$12,000) were twice those with only one illness (>$5,900 for HIV, >$4,100 for SMI), and twelve times controls (<$1,000). We conclude that the rate infection in the SMI population in Philadelphia is three to five times the general Medicaid population. We suggest that HIV prevention be part of standard clinical practice within the specialty mental health sector, and that cost savings will be substantial.
Learning Objectives: At the conclusion of the session, the participant (learner) will be able to
Keywords: HIV/AIDS, Mental Disorders
Related Web page: www.uphs.upenn.edu/cmhpsr/
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.