Durbin A, Brown H K, Bansal S, Antoniou T, Jung J K H, Lunsky Y
Epidemiology Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
J Intellect Disabil Res. 2017 Jul;61(7):682-696. doi: 10.1111/jir.12381.
OBJECTIVE(S): Although rates of human immunodeficiency virus (HIV) are similar for individuals with and without intellectual and developmental disabilities (IDD), very little is known about the health needs and service use of those with IDD and HIV. Among a population with IDD, we compared the physical and mental health profiles, as well as general and mental health service use for those with and without HIV.
Retrospective cohort study in Ontario, Canada using linked administrative health and social service databases.
The prevalence of physical conditions and mental health disorders, and patterns of service use for any reason and service use for mental health issues were compared among Ontario adults with IDD and HIV (n = 107) and without HIV (n = 63 901) in log-binomial models adjusted for age, sex and neighbourhood income and rurality.
Adults with IDD and HIV were more likely than those without HIV to have three types of mental health disorders: non-psychotic disorders [aRR: adjusted rate ratio (aRR): 1.22 (95% confidence interval (CI): 1.01-1.47)], psychotic disorders [aRR: 1.57 (1.09, 2.28)] and substance use disorders [aRR: 3.52 (2.53, 4.91)]. Adults with IDD and HIV were also more likely to have emergency department visits [aRR: 1.68 (1.42, 1.98)] and hospital admissions [aRR: 2.55 (1.74, 3.73)] for any reason, and to have mental health emergency department visits and/or admissions [aRR: 2.82 (1.90, 4.18)].
Adults with IDD and HIV have complex health profiles and greater health service use than HIV-negative adults with IDD. These findings call for closer integration of programs delivered by the HIV and disability sectors to optimise the health of this patient population.
尽管有智力和发育障碍（IDD）者与无智力和发育障碍者的人类免疫缺陷病毒（HIV）感染率相似，但对于患有IDD和HIV者的健康需求及服务利用情况却知之甚少。在一个患有IDD的人群中，我们比较了患有和未患有HIV者的身心健康状况，以及一般和心理健康服务的利用情况。
在加拿大安大略省进行的一项回顾性队列研究，使用了关联的行政健康和社会服务数据库。
在对数二项模型中，比较了安大略省患有IDD且感染HIV（n = 107）和未感染HIV（n = 63901）的成年人的身体状况和心理健康障碍的患病率，以及因任何原因的服务利用模式和心理健康问题的服务利用模式，并对年龄、性别、邻里收入和农村地区进行了调整。
患有IDD和HIV的成年人比未感染HIV的成年人更易患三种心理健康障碍：非精神病性障碍[调整率比（aRR）：1.22（95%置信区间（CI）：1.01 - 1.47）]、精神病性障碍[aRR：1.57（1.09，2.28）]和物质使用障碍[aRR：3.52（2.53，4.91）]。患有IDD和HIV的成年人也更有可能因任何原因前往急诊科就诊[aRR：1.68（1.42，1.98）]和住院治疗[aRR：2.55（1.74，3.73）]，以及因心理健康问题前往急诊科就诊和/或住院治疗[aRR：2.82（1.90，4.18）]。
患有IDD和HIV的成年人具有复杂的健康状况，比未感染HIV的IDD成年人更多地利用健康服务。这些发现要求HIV和残疾部门提供的项目更紧密地整合，以优化这一患者群体的健康状况。
