HIV testing among adults with chronic mental illness in Brazil
A.P. Melo1, C. Machado2, G. Mark3
1Raul Soares Institute and Teaching Hospital, State Health Department, FHEMIG, Belo Horizonte, Brazil, 2Universidade Federal de Minas Gerais, Faculdade de Ciências Econômicas, Centro de Desenvolvimento e Planejamento Regional., Belo Horizonte, Brazil, 3Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Objective: The purpose of this study was to determine rates of lifetime testing for HIV and assess whether sociodemographic and clinical characteristics were associated with previous HIV testing in psychiatric patients.
Method: Cross-sectional national multicenter study among 2475 chronic mental illness randomly selected from 26 Brazilian mental health institutions. Multivariate logistic regression analysis was used to assess association between patients´ characteristics and previous lifetime HIV testing.
Results: The rate of previous lifetime HIV testing was 27%. Most participants were female (52%), ≤40 years old (48%), with low schooling (59%), and had previous psychiatric hospitalization (60%), schizophrenia as primary diagnosis (48%). Lifetime HIV testing was independently associated with living alone (OR= 1.53, 95%CI: 1.15 - 2.03), history of homelessness (OR= 1.34, 95%CI:1.03 - 1.75), history of any STD (OR= 1.45, 95%CI: 1.15- 1.82), other self-reported medical conditions (OR= 1.27 95%CI: 1.03 - 1.56), better HIV/AIDS knowledge (OR=1.65 95%CI: 1.23- 2.20), use of alcohol in the last month (OR= 1.36, 95%CI: 1.08 - 1.70), use of crack in the last year (OR= 1.77, 95%CI: 1.19 - 2.64), having private health insurance( OR=1.32, 95%CI: 0.97 - 1.80). Nevertheless, lifetime HIV testing were inversely associated with being single (OR= 0.70, 95%CI: 0.56 - 0.87), with low schooling (OR= 0.58, 95%CI: 0.47- 0.72), older than 40 years old (OR= 0.52, 95%CI: 0.42 - 0.65), could not report prescribed psychiatric medication (OR= 0.72, 95%CI: 0.57- 0.91), and never having had sexual intercourse (OR= 0.25 95%CI: 0.14 - 0.44).
Conclusion: The findings stress the need to increase HIV testing and awareness of HIV serostatus among chronic mental illness. Mental Health providers must be encouraged to play a more active role in increasing the numbers of patients who are tested and should consider novel strategies for implementing more effective HIV/STIs interventions in this population.
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