Mangurian Christina, Cournos Francine, Schillinger Dean, Vittinghoff Eric, Creasman Jennifer M, Lee Bernard, Knapp Penelope, Fuentes-Afflick Elena, Dilley James W
Dr. Mangurian, Mr. Lee, and Dr. Dilley are with the Department of Psychiatry and the Weill Institute for Neurosciences; Dr. Schillinger is with the Department of Medicine; Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics; Ms. Creasman is with the Clinical and Translational Science Institute (CTSI); and Dr. Fuentes-Afflick is with the Department of Pediatrics, all at the School of Medicine, University of California, San Francisco (UCSF) (e-mail:
Psychiatr Serv. 2017 May 1;68(5):443-448. doi: 10.1176/appi.ps.201600248. Epub 2017 Jan 17.
This research aimed to characterize HIV testing rates among Medicaid recipients with severe mental illness who received public specialty mental health services.
This retrospective cohort study examined California Medicaid records from October 1, 2010, to September 30, 2011 (N=56,895). Study participants were between age 18 and 67, utilized specialty mental health care services, were prescribed antipsychotic medications, and were not dually eligible for Medicare. Adjusted Poisson regression models were used to estimate the overall effects of predictor variables on HIV testing prevalence.
During the study period, 6.7% of people with severe mental illness received HIV testing. Men were 32% less likely to be tested for HIV than women (p<.001). Compared with whites, Asians/Pacific Islanders were 53% less likely and blacks were 82% more likely to be tested (p<.001). Those with comorbid drug or alcohol use disorders were more likely to be tested than those without such disorders (p<.001). Utilization of nonpsychiatric medical care was the strongest predictor of HIV testing (p<.001).
Most adults with severe mental illness receiving public specialty mental health services were not tested for HIV during a one-year period. Public health administrators must prioritize HIV testing for early identification of HIV infection and prevention of HIV transmission.
本研究旨在描述接受公共专科心理健康服务的患有严重精神疾病的医疗补助领取者的艾滋病毒检测率。
这项回顾性队列研究检查了2010年10月1日至2011年9月30日期间加利福尼亚州的医疗补助记录（N = 56,895）。研究参与者年龄在18至67岁之间，使用专科心理健康护理服务，开具了抗精神病药物，且不符合医疗保险双重资格。使用调整后的泊松回归模型来估计预测变量对艾滋病毒检测患病率的总体影响。
在研究期间，6.7%的严重精神疾病患者接受了艾滋病毒检测。男性接受艾滋病毒检测的可能性比女性低32%（p <.001）。与白人相比，亚裔/太平洋岛民接受检测的可能性低53%，黑人接受检测的可能性高82%（p <.001）。患有药物或酒精使用障碍合并症的人比没有此类障碍的人更有可能接受检测（p <.001）。使用非精神科医疗护理是艾滋病毒检测的最强预测因素（p <.001）。
在一年期间，大多数接受公共专科心理健康服务的严重精神疾病成年人未接受艾滋病毒检测。公共卫生管理人员必须将艾滋病毒检测作为优先事项，以便早期发现艾滋病毒感染并预防艾滋病毒传播。
