People with Mental Illness More Likely To Be Tested for HIV, Penn Medicine Study Finds
First study to investigate rate of HIV testing in patients with specific mental illnesses
December 4, 2014 - PHILADELPHIA - People with mental illness are more likely to have been tested for HIV
than those without mental illness, according to a new study from a team of
researchers at Penn Medicine and the U.S. Centers for Disease Control and
Prevention (CDC) published online this week in AIDS Patient Care and STDs. The researchers also found that the most seriously
ill - those with schizophrenia and bipolar disease - had the highest rate of HIV testing.
The study assessed nationally representative data from 21,785 adult respondents from the 2007 National Health Interview Survey (NHIS)
and provides an update of prior research using 1999 and 2002 NHIS data. The 2007 version is the most recent cycle of the survey that
included information both on mental health diagnoses and HIV testing.
The current Penn-led study adds precision to earlier research by reporting on HIV-testing rates according to specific mental health
diagnoses; previous studies did not differentiate persons with, for example, depression, bipolar disorder, and schizophrenia spectrum
The researchers found that 15 percent of respondents reported a psychiatric disorder. Of these, 89 percent had symptoms of depression
and/or anxiety, 8.5 percent had bipolar disorder, and 2.6 percent had schizophrenia spectrum disorder. Among persons reporting at
least one mental illness, 48.5 percent had been tested for HIV. The 48.5 percent rate compares to a testing rate of 35 percent
among those without mental illness. More specifically, 64 percent of persons with schizophrenia, 63 percent of persons
with bipolar disorder, and 47 percent of persons with depression and/or anxiety reported ever being tested for HIV.
"Our study shows that persons with mental illness and/or their care providers recognize that they are at higher risk and should be
tested," said senior author Michael B. Blank, PhD,
associate professor in Psychiatry at Penn and co-director of the Penn Mental Health AIDS Research Center. "However,
by no means we should be complacent since these results may in large part be due to individual vigilance. The fact is there are few
formal prevention and screening efforts targeted at this at-risk population. In light of the fact that mentally ill people are
more likely to engage in risky behavior, mental health providers should consider routinely offering HIV/AIDS testing,
something that does not typically occur now."
HIV infection and mental illness are often co-occurring health conditions, with nearly half of persons living with HIV having a psychiatric
disorder while between 5-23 percent of those with mental illness are infected with HIV.
In addition, the study found that persons aged 25-44, women, racial and ethnic minorities, individuals who are windowed/divorced/separated,
those reporting excessive use of alcohol or tobacco, and persons with HIV risk factors were significantly more likely to be tested for
HIV than their counterparts.
Separate research has found that mentally ill individuals are more likely than others to engage in high-risk behaviors associated with
HIV transmission, including unprotected sexual intercourse, injection drug use, and sex with multiple partners.
"Our finding that persons with mental illness were tested for HIV at a higher rate than those without mental illness is encouraging and
consistent with previous analyses," said lead author Baligh R. Yehia, MD, MPP, MSHP, assistant
professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Medicine Program for LGBT Health . "However, the large number of people with mental illness who still have not been tested necessitates increased public health prevention efforts, particularly in light of the increased HIV risk in this population."
The CDC recommends that all persons aged 13-64 be tested for HIV in healthcare settings and that persons with increased risk such as
injecting drug users and their sex partners, sex workers, men who have sex with men, and heterosexuals with multiple sex partners
be tested at least annually.
Co-authors include Wanjun Cui, PhD; William W. Thompson, PhD; Matthew M. Zack, MD, MPH; Lela McKnight-Eily, PhD; Elizabeth DiNenno, PhD;
and Charles E. Rose, PhD, all from the CDC.
The research was supported by the National Institutes of Health (K23-MH097647), Centers for Disease Control and Prevention (U18-PS000704),
Penn Center for AIDS Research (P30-AI045008), and the Penn Mental Health AIDS Research Center (P30-MH097488).
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical
research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the
nation's first medical school) and the University of Pennsylvania Health System which
together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according
to U.S. News & World Report 's survey of research-oriented medical schools. The School is consistently among the nation's top
recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized
as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report ; Penn Presbyterian Medical Center; Chester
County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional
affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and
Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year
2013, Penn Medicine provided $814 million to benefit our community.
Source: Penn Medicine: University of Pennsylvania
"Reproduced with permission - Penn Medicine: University of Pennsylvania"
Penn Medicine: University of Pennsylvania
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