Social, demographic and clinical characteristics of female patients with schizophrenia and HIV

Бурыгина, Л А; Orlov, V. A.; Zhilenkova, A V; Makaryan, D E; Khannanova, A.N.; Орлова, А. С.; Акарачкова, Е. С.

doi:10.17116/jnevro202112101131

Cited by 1 publication

(1 citation statement)

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“…People with schizophrenia in the United States face multiple barriers to receiving appropriate HIV/AIDS treatment, including siloed mental health and physical health services [9,10]. The presence of these structural challenges suggests that people with schizophrenia and other serious mental illnesses should be categorized as an HIV/AIDS high-risk population, especially because receiving treatment for HIV/AIDS reduces psychiatric morbidity [11], and HIV-related psychiatric and neurocognitive complications impact psychiatric presentation [12]. Such categorization could encourage routine testing and early detection of HIV.…”

Section: Discussionmentioning

confidence: 99%

Underdetection of pre-existing HIV/AIDS during psychiatric hospitalizations

Mangurian

Goldman

Corbeil³

et al. 2022

Aids

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Objectives:People with severe mental illness are 10 times more likely to have HIV/ AIDS than the general population, yet little is known about the characteristics and frequency of recognition of pre-existing HIV/AIDS diagnoses among inpatients with severe mental illness. This study examines documentation rates of pre-existing HIV/ AIDS among inpatients within psychiatric hospitals in New York State.Design:Retrospective cohort study to examine recognition of pre-existing HIV/AIDS among psychiatric inpatients.Methods:Patient-level Medicaid claims records were linked with hospital and regional data for people admitted to psychiatric inpatient units in New York State. Presence of HIV/AIDS diagnoses prior to psychiatric hospitalization was coded for each inpatient (n = 14 602). Adjusted odds ratios of undocumented HIV/AIDS diagnoses at the time of discharge were calculated using logistic regression analyses.Results:About 5.1% (741/14 602) of unique psychiatric inpatients had pre-existing HIV/AIDS diagnoses. Of these inpatients, 58.3% (432/741) were not coded as having HIV/AIDS upon discharge. Higher rates of missed detection were associated with younger age, non-Hispanic white race/ethnicity, shorter length of stay, more distal coding of an HIV/AIDS diagnosis, and fewer HIV/AIDS-related Medicaid claims in the past year. Hospitals with higher readmission rates also had higher rates of undetected HIV/AIDS diagnoses.Conclusion:Over half of inpatients previously diagnosed with HIV/AIDS did not have their HIV-positive status noted upon discharge from psychiatric hospitalization. This finding underscores how frequently clinically significant medical comorbidities fail to be incorporated into psychiatric treatment and treatment planning. Inpatient clinicians are missing important opportunities to optimize HIV/AIDS treatment and reduce morbidity and mortality.

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