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Mental Illness Increases the Risk of HIV Infection

Blank MB, Mandell DS, Aiken L, Hadley TR. Co-occurrence of HIV and serious mental illness among Medicaid recipients. Psychiatric Services. 2002;53:868-873.

Although statistics from 1997 show a slight decline in the number of new cases of AIDS in the United States, the incidence of HIV infection continues to grow because improved therapies have prolonged life with the disease. Previous studies have shown that persons with mental illness have an increased prevalence of HIV-related diseases, and these persons often display multiple HIV risk factors, including poverty, substance abuse, and engaging in unprotected sex. From reviewing more than 390,000 Medicaid records from Philadelphia for the 3-year period between July 1993 and June 1996, researchers evaluated the incidence and co-occurrence of HIV and serious mental illness. The sample was 59% black, 24% white, and 11% Hispanic, 58% were women, and the average age was 40 years. A diagnosis of an HIV-related condition occurred in 0.6% of cases among persons without an accompanying diagnosis of schizophrenia or affective disorder, and in 1.8% of those who had these problems. Medicaid patients diagnosed with serious mental illness were roughly 5 times as likely to have HIV as unaffected persons. While this study gives no indication of causality between HIV and mental illness, the high co-occurrence of these conditions merits further study for both prevention and treatment.