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APHA Scientific Session and Event Listing

Seth Himelhoch, MD, MPH¹, John F. McCarthy, PhD, MPH², Dara Ganoczy, MPH², Lisa Dixon, MD, MPH¹, and Frederic Blow, PhD². (1) Department of Pyschiatry, University of Maryland, 737 W. Lombard Street, Baltimore, MD 21201, (410) 706-2490, shimelho@psych.umaryland.edu, (2) Department of Psychiatry, University of Michigan, Veterans Affairs, SMITREC (11H), P.O. Box 130170, Ann Arbor, MI 48113-0170

Context: Although individuals with serious mental illnesses (SMI) have a high prevalence of HIV, the nature of this association remains poorly understood. Objective: To determine the prevalence of HIV among a national population of individuals with SMI as compared to a non-SMI control group. Design: A cross-sectional study of veterans during the fiscal year 2002 (FY02). Individuals who received SMI diagnoses (i.e., schizophrenia, bipolar disorder, and non-organic psychoses) in FY02 (N=191,625) vs. individuals in a random sample of VA patients in FY02 who did not receive SMI diagnoses (N = 67,965). Results: HIV diagnoses were recorded for 1.0% of patients with SMI, compared to 0.5% of non-SMI patients. Multivariate analyses indicated that individuals with bipolar disorder were no more likely to have HIV (OR [95% CI]: 1.08 [0.93-1.24]), while those with non-organic psychoses were 18% more likely to have HIV (OR [95% CI]: 1.18 [1.01-1.38]). A significant interaction was observed between schizophrenia diagnosis and substance abuse. Compared to patients without SMI, schizophrenia patients without substance abuse were 50% less likely to have HIV (OR [95% CI]: 0.49 [0.42-0.58]), while those with substance abuse were 22% more likely to have HIV (OR [95% CI]: 1.22 [1.04-1.43]). Conclusions: Despite the elevated crude prevalence of HIV, multivariate analyses indicated that HIV-related risk factors significantly underlie the observed associations between HIV and each of the SMI subgroups. For patients with schizophrenia, this study is the first to demonstrate significantly reduced HIV risk in the absence of substance use

Learning Objectives:

• Recognize that those with Serious Mental Illness are at risk for HIV
• Recognize that behavioral risk factors associated with HIV underlie the risk of HIV among those with SMI

Keywords: Sever Mental Illness, HIV/AIDS

Presenting author's disclosure statement:

Any relevant financial relationships? No