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Himelhoch, McCarthy, et al. (2007) "examined data from a national sample of veterans who received a diagnosis of serious mental illness [SMI] (schizophrenia, bipolar disorder, and other, nonorganic psychoses) in fiscal year 2002 (FY2002) (N=191,625) and from a national random sample of veterans in FY2002 who did not receive [SMI] diagnoses (N=67,965)" (p. 1165). Himelhoch and colleagues found that the crude recorded prevalence of HIV was 1.0% among persons with SMI and 0.5% among persons without SMI.
Multivariate analyses indicated that individuals with bipolar disorder were no more likely than those without … [any SMI] to have a recorded HIV diagnosis ..., whereas those with other[, nonorganic] psychoses were more likely to have one ... . An interaction was observed between schizophrenia and substance use disorder. Compared with patients who had neither schizophrenia nor a substance use disorder, those with schizophrenia without a substance use disorder were less likely to have a recorded HIV diagnosis ..., whereas those with a substance use disorder were more likely to have … [one]. (p. 1165)
The investigators reason that,
[g]iven the continued risk for HIV in this vulnerable population ..., ongoing efforts by mental health providers to provide consistent primary and secondary HIV prevention education … [are] warranted ... . This may be particularly important for individuals with schizophrenia who are known to be abusing drugs or alcohol, because the findings indicate that patients with schizophrenia who also had a substance use disorder were at greater risk of being diagnosed as having HIV. It also may be particularly important for mental health professionals to monitor ... and maximize psychiatric treatment interventions that may reduce the risk during an acute psychiatric episode of high-risk sexual behavior or use of illicit substances – for example, optimizing treatment of bipolar disorder to prevent mania. (p. 1171)
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Winter 2008 Newsletter / Volume 9, Issue 2
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