HIV-1 among Inner City Dually Diagnosed Inpatients

Abstract

The objectives of this study were to investigate HIV-1 seroprevalence and risk factors, disease progression, and awareness of HIV-1 serostatus in a population of inner city, substance using, psychiatric inpatients. To pursue these goals, we tested 118 (103 M, 15 F) dually diagnosed, acute care inpatients for HIV-1 antibodies and administered structured interviews. Twenty-seven (23%, including 24 M and 3 F) of the subjects were HIV-1 seropositive. Seropositivity was twice as great among intravenous drug users and men who had sex with other men as among patients not belonging to either of these two groups. Logistic regression analysis among male subjects revealed a significantly elevated HIV-1 risk associated with a primary diagnosis of depression (odds ratio adjusted for age, race, and presence of an AIDS risk behavior = 4.2, 95% confidence interval = 1.1, 16.5; p = 0.04). Less than half of the seropositives knew their HIV-1 status prior to this study, one had AIDS and four had two or more constitutional symptoms of AIDS. The high rate of seropositivity in this indigent, dually diagnosed population presents challenges to the health-care community. That few individuals had HIV-1 related symptoms may have implications for other treatment settings.

Physical illness and schizophrenia: a review of the literature

“…Many studies on the association between schizophrenia and the human immunodeficiency virus (HIV) positivity were found. Although the prevalence of HIV positivity in people with schizophrenia was generally higher than in the general population (0.6% in the general population of America according to a WHO statistic) (21), the prevalence varied substantially [1.3-22.9% (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)]. This variability probably reflects a different degrees of prevalence of HIV positivity in different parts of the world.…”

HIV issues and people with disabilities: A review and agenda for research

“…Two studies found that HIV risk behaviours are associated with severity of mental health disability (Rosenberg et al, 2005;Heaphy et al, 2010), although a third study did not find any significant associations with different mental health disabilities (Collins et al, 2009). Depression and post-traumatic stress disorder were also found to be associated with higher HIV risk (Hoff et al, 1997;Silberstein et al, 1994).…”

Access to HAART and utilization of inpatient medical hospital services among HIV-infected patients with co-occurring serious mental illness and injection drug use

“…[1] Estimates from samples during the 1990s suggest that the prevalence of HIV among individuals with SMI ranges from 3-23%. [2][3][4][5][6][7][8][9][10] Highly active antiretroviral therapy (HAART) has revolutionized the treatment of HIV leading to significant declines in HIV related morbidity and mortality as well as declines in hospitalization. [11][12][13][14][15][16][17] Although previous studies suggest that individuals with SMI are less likely to receive potentially life saving interventions for non-HIV-related chronic conditions, [18;19] few studies have evaluated the degree to which HIV infected individuals with SMI receive HAART.…”