Study Notes Missed Opportunity for HIV Detection

According to the CDC, approximately 16% of the estimated 1.2 million individuals in the United States with HIV are unaware of their infection. A new study, published in Psychiatric Services, reveals a missed opportunity for early HIV detection and treatment.¹ The findings show that individuals with mental illnesses are more likely to become infected with HIV than their healthy counterparts.

Patients who have mental illnesses, such as bipolar disorder, schizophrenia, and major depression, are up to 15 times more likely to contract HIV. Despite being at a higher risk for HIV, patients with these mental illnesses often exhibit similar testing rates to those without mental illnesses, indicating that more testing needs to be initiated to improve patient outcomes.

Results are based on a study that included 56,895 Medicaid patients in California between the ages of 18 and 67, who were taking medications to treat various mental illnesses. The researchers concluded that 6.7% of the patients received HIV testing, compared to 5.2% of the state’s general population.

“People with severe mental illness have higher rates of unsafe behaviors that put them at risk for HIV infection,” Christina Mangurian, MD, MAS, of the UCSF Department of Psychiatry, said in a news release.² “This includes engaging in unprotected sex with HIV positive partners and partners of unknown HIV status, injecting drugs, using substances in the context of sexual activity and episodes of sexual violence.”

Most of the individuals receiving public specialty mental health services were not tested for HIV during a 1-year period. The study’s findings suggest a missed opportunity for early detection of HIV in those with severe mental illnesses, and the researchers recommend that public mental health administrators consider annual HIV testing for patients. Pharmacists can play an important role by providing preventive counseling and urging patients who are being treated for severe mental illnesses to receive HIV testing.

References

• Mangurian C, Cournos F, Schillinger D, et al. Low Rates of HIV Testing Among Adults With Severe Mental Illness Receiving Care in Community Mental Health Settings. Psychiatric Services. 2017; http://ps.psychiatryonline.org/doi/suppl/10.1176/appi.ps.201600248

2. Patients with Severe Mental Illnesses Slip Between Cracks in HIV Testing [news release]. California. UCSF’s website. https://www.ucsf.edu/news/2017/01/405526/patients-severe-mental-illnesses-slip-between-cracks-hiv-testing. Accessed Jan. 24, 2017.