HIV testing and mental illness in New York City: Results from the 2009 New York City community health survey

BACKGROUND: HIV prevalence and incidence estimates are higher among individuals with mental health disorders than the general population. This analysis seeks to identify whether New York City adults with a history of mental illness are more likely to report recent HIV testing than those without a history of mental illness. METHODS: Multivariable logistic regression using data from the NYC 2009 Community Health Survey (n=9,934) estimated the association of mental illness (past depression diagnosis and/or current frequent mental distress) with HIV testing in the past year, adjusting for potential confounding factors (demographics, insurance type, condom use). RESULTS: Sixteen percent of respondents had a mental illness history; 34% of this group reported a recent HIV test compared to 30% of adults without a mental illness history (p=0.01). In multivariable models, mental illness was associated with a higher likelihood of recent testing (adjusted odds ratio, aOR, 1.28, 95%CI: 1.04, 1.57). Compared to being uninsured, having insurance was not associated with a higher likelihood of recent testing but having Medicaid was (aOR 1.96, 95%CI: 1.48, 2.60), and this association remained in analyses stratified by mental illness. CONCLUSION: Those with a history of mental illness are more likely to report a recent HIV test, even controlling for confounders. Regardless of mental health history, having Medicaid was associated with a higher likelihood of recent testing, even though being insured in general did not show this relationship. Policy makers should ensure enrollment into Medicaid can be done quickly and seamlessly to leverage its impact on HIV testing.