Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-19T20:28:15.189Z Has data issue: false hasContentIssue false

HIV testing among individuals with a severe mental illness: review, suggestions for research, and clinical implications

Published online by Cambridge University Press:  08 July 2008

T. E. Senn*
Affiliation:
Center for Health and Behavior, Syracuse University, Syracuse, NY, USA
M. P. Carey
Affiliation:
Center for Health and Behavior, Syracuse University, Syracuse, NY, USA
*
*Address for correspondence: T. E. Senn, Center for Health and Behavior, 430 Huntington Hall, Syracuse University, Syracuse, NY 13244, USA. (Email: [email protected])

Abstract

Background

The prevalence of human immunodeficiency virus (HIV) is elevated among individuals with a severe mental illness (SMI). Because of the benefits of HIV testing, it is important for individuals with SMI to have routine access to testing. The goals of this review are: to summarize knowledge about HIV testing prevalence, correlates, and interventions among individuals with an SMI; to identify research needs; and to discuss clinical implications of the studies reviewed.

Method

Literature searches were conducted using PsycINFO, PubMed, and Medline. Additional articles were obtained from reference lists of relevant articles.

Results

Fewer than one-half of individuals with an SMI have been tested for HIV in the past year. Engaging in sex or drug risk behavior was the only consistent correlate of HIV testing. Interventions for promoting HIV testing among individuals with an SMI have not been well developed or evaluated.

Conclusions

Research on HIV testing among individuals with an SMI is needed. Mental health settings may be opportune venues for HIV testing, even though providers face ethical challenges when implementing testing programs in these settings.

Type
Review Article
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blumberg, SJ, Dickey, WC (2003). Prevalence of HIV risk behaviors, risk perceptions, and testing among US adults with mental disorders. Journal of Acquired Immune Deficiency Syndromes 32, 7779.CrossRefGoogle ScholarPubMed
Bogart, LM, Kelly, JA, Catz, SL, Sosman, JM (2000). Impact of medical and nonmedical factors on physician decision making for HIV/AIDS antiretroviral treatment. Journal of Acquired Immune Deficiency Syndromes 23, 396404.CrossRefGoogle ScholarPubMed
Carey, MP, Carey, KB, Kalichman, SC (1997). Risk for human immunodeficiency virus (HIV) infection among persons with severe mental illness. Clinical Psychology Review 17, 271291.CrossRefGoogle Scholar
Carey, MP, Carey, KB, Maisto, SA, Schroder, KEE, Vanable, PA, Gordon, CM (2004). HIV risk behavior among psychiatric outpatients: association with psychiatric disorder, substance use disorder, and gender. Journal of Nervous and Mental Disease 192, 289296.CrossRefGoogle ScholarPubMed
Carey, MP, Coury-Doniger, P, Senn, TE, Vanable, PA, Urban, MA (in press). Improving HIV rapid testing rates among STD clinic patients: a randomized, controlled trial. Health Psychology.Google Scholar
Centers for Disease Control and Prevention (2003 a). HIV/AIDS Special Surveillance Report: HIV Testing Survey, 2000. US Department of Health and Human Services: Atlanta, GA.Google Scholar
Centers for Disease Control and Prevention (2003 b). Late versus early testing of HIV – 16 sites, United States, 2000–2003. Morbidity and Mortality Weekly Report 52, 581586.Google Scholar
Cournos, F, McKinnon, K (1997). HIV seroprevalence among people with severe mental illness in the United States: a critical review. Clinical Psychology Review 17, 259269.CrossRefGoogle ScholarPubMed
Desai, MM, Rosenheck, RA (2004). HIV testing and receipt of test results among homeless persons with serious mental illness. American Journal of Psychiatry 161, 22872294.CrossRefGoogle ScholarPubMed
Desai, MM, Rosenheck, RA, Desai, RA (2007). Prevalence and correlates of human immunodeficiency virus testing and posttest counseling among outpatients with serious mental illness. Journal of Nervous and Mental Disease 195, 776780.CrossRefGoogle ScholarPubMed
Fairfield, KM, Libman, H, Davis, RB, Eisenberg, DM, Phillips, RS (1999). Delays in protease inhibitor use in clinical practice. Journal of General Internal Medicine 14, 395401.CrossRefGoogle ScholarPubMed
Goldberg, RW (2004). Letter to the Editor: Hepatitis and HIV screening, education, and treatment for adults with serious mental illness. General Hospital Psychiatry 26, 167168.CrossRefGoogle Scholar
Goldberg, RW, Himelhoch, S, Kreyenbuhl, J, Dickerson, FB, Hackman, A, Fang, LJ, Brown, CH, Wohlheiter, KA, Dixon, LB (2005). Predictors of HIV and hepatitis testing and related service utilization among individuals with serious mental illness. Psychosomatics 46, 573577.CrossRefGoogle ScholarPubMed
Gordon, CM, Carey, MP, Carey, KB, Maisto, SA, Weinhardt, LS (1999). Understanding HIV-related risk among persons with a severe and persistent mental illness: insights from qualitative inquiry. Journal of Nervous and Mental Disease 187, 208216.CrossRefGoogle ScholarPubMed
Grassi, L, Pavanati, M, Cardelli, R, Ferri, S, Peron, L (1999). HIV-risk behaviour and knowledge about HIV/AIDS among patients with schizophrenia. Psychological Medicine 29, 171179.CrossRefGoogle ScholarPubMed
Haimowitz, S (1996). An overview of legal issues. In AIDS and People with Severe Mental Illness (ed. Cournos, F. and Bakalar, N.), pp. 227239. Yale University Press: New Haven, CT.Google Scholar
Himelhoch, S, McCarthy, JF, Ganoczy, D, Medoff, D, Dixon, LB, Blow, FC (2007). Understanding associations between serious mental illness and HIV among patients in the VA health system. Psychiatric Services 58, 11651172.CrossRefGoogle ScholarPubMed
Kalichman, S, Malow, R, Devieux, J, Stein, JA, Piedman, F (2005). HIV risk reduction for substance using seriously mentally ill adults: Test of the Information-Motivation-Behavior Skills (IMB) model. Community Mental Health Journal 41, 277290.CrossRefGoogle ScholarPubMed
Katz, RC, Watts, C, Santman, J (1994). AIDS knowledge and high risk behaviors in the chronic mentally ill. Community Mental Health Journal 30, 395401.CrossRefGoogle ScholarPubMed
Kelly, JA, Murphy, DA, Bahr, GR, Brasfield, TL, Davis, DR, Hauth, AC, Morgan, MG, Stevenson, LY, Eilers, MK (1992). AIDS/HIV risk behavior among the chronic mentally ill. American Journal of Psychiatry 149, 886889.Google ScholarPubMed
Knox, MD, Boaz, TL, Friedrich, MA, Dow, MG (1994). HIV risk factors for persons with serious mental illness. Community Mental Health Journal 30, 551563.CrossRefGoogle ScholarPubMed
Levounis, P, Galanter, M, Dermatis, H, Hamowy, A, De Leon, G (2002). Correlates of HIV transmission risk factors and considerations for interventions in homeless, chemically addicted and mentally ill patients. Journal of Addictive Diseases 21, 6172.CrossRefGoogle ScholarPubMed
Marks, G, Crepaz, N, Senterfitt, W, Janssen, RS (2005). Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States. Journal of Acquired Immune Deficiency Syndromes 39, 446453.CrossRefGoogle ScholarPubMed
McKinnon, K, Cournos, F, Herman, R (2002). HIV among people with chronic mental illness. Psychiatric Quarterly 73, 1731.CrossRefGoogle ScholarPubMed
McQuillan, GM, Kruszon-Moran, D, Kottiri, BJ, Kamimoto, LA, Lam, L, Cowart, MF, Hubbard, M, Spira, TJ (2006). Prevalence of HIV in the US household population: The National Health and Nutrition Examination Surveys, 1988 to 2002. Journal of Acquired Immune Deficiency Syndromes 41, 651656.CrossRefGoogle ScholarPubMed
Meade, CS, Sikkema, KJ (2005 a). HIV risk behavior among adults with severe mental illness: a systematic review. Clinical Psychology Review 25, 433457.CrossRefGoogle ScholarPubMed
Meade, CS, Sikkema, KJ (2005 b). Voluntary HIV testing among adults with severe mental illness: frequency and associated factors. AIDS and Behavior 9, 465473.CrossRefGoogle ScholarPubMed
Meade, CS, Sikkema, KJ (2007). Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness. Community Mental Health Journal 43, 153169.CrossRefGoogle ScholarPubMed
Meade, CS, Weiss, RD (2007). Substance abuse as a risk factor for HIV sexual risk behavior among persons with severe mental illness: review of evidence and exploration of mechanisms. Clinical Psychology: Science and Practice 14, 2333.Google Scholar
Meyer, JM (2003). Prevalence of hepatitis A, hepatitis B, and HIV among hepatitis C-seropositive state hospital patients: results from Oregon State Hospital. Journal of Clinical Psychiatry 64, 540545.CrossRefGoogle ScholarPubMed
Miller, LJ, Finnerty, M (1996). Sexuality, pregnancy, and childrearing among women with schizophrenia-spectrum disorders. Psychiatric Services 47, 502506.Google ScholarPubMed
Mimiaga, MJ, Goldhammer, H, Belanoff, C, Tetu, AM, Mayer, KH (2007). Men who have sex with men: perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sexually Transmitted Diseases 34, 113119.CrossRefGoogle ScholarPubMed
Odunsi, B (2007). Should caregivers be compelled to disclose patients' HIV infection to the patients' sex partners without consent? Studies in Family Planning 38, 297306.CrossRefGoogle Scholar
Otto-Salaj, LL, Heckman, TG, Stevenson, LY, Kelly, JA (1998). Patterns, predictors, and gender differences in HIV risk among severely mentally ill men and women. Community Mental Health Journal 34, 175190.CrossRefGoogle ScholarPubMed
Parry, CD, Blank, MB, Pithey, AL (2007). Responding to the threat of HIV among persons with mental illness and substance abuse. Current Opinion in Psychiatry 20, 235241.CrossRefGoogle Scholar
Pirl, WF, Greer, JA, Weissgarber, C, Liverant, G, Safren, SA (2005). Screening for infectious diseases among patients in a state psychiatric hospital. Psychiatric Services 56, 16141616.CrossRefGoogle Scholar
Randolph, ME, Pinkerton, SD, Somlai, AM, Kelly, JA, McAuliffe, TL, Gibson, RH, Hackl, K (2007). Severely mentally ill women's HIV risk: the influence of social support, substance use, and contextual risk factors. Community Mental Health Journal 43, 3347.CrossRefGoogle ScholarPubMed
Rosenberg, S, Brunette, M, Oxman, T, Marsh, B, Dietrich, A, Mueser, K, Drake, R, Torrey, W, Vidaver, R (2004). The STIRR model of best practices for blood-borne diseases among clients with serious mental illness. Psychiatric Services 55, 660664.CrossRefGoogle ScholarPubMed
Satriano, J, McKinnon, K, Adoff, S (2007). HIV service provision for people with severe mental illness in outpatient mental health care settings in New York. Journal of Prevention and Intervention in the Community 33, 95108.CrossRefGoogle ScholarPubMed
Simon, PA, Weber, M, Ford, WL, Cheng, F, Kerndt, PR (1996). Reasons for HIV antibody test refusal in a heterosexual sexually transmitted disease clinic population. AIDS 10, 15491553.CrossRefGoogle Scholar
Simoni, JM, Frick, PA, Pantalone, DW, Turner, BJ (2003). Antiretroviral adherence interventions: a review of current literature and ongoing studies. Topics in HIV Medicine 11, 185198.Google Scholar
Solomon, PL, Tennille, JA, Lipsitt, D, Plumb, E, Metzger, D, Blank, MB (2007). Rapid assessment of existing HIV prevention programming in a community mental health center. Journal of Prevention and Intervention in the Community 33, 137151.CrossRefGoogle Scholar
Strauss, JL, Bosworth, HB, Stechuchak, KM, Meador, KM, Butterfield, MI (2006). Knowledge and risks of human immunodeficiency virus transmission among veterans with severe mental illness. Military Medicine 171, 325330.CrossRefGoogle ScholarPubMed
Thompson, SC, Checkley, GE, Hocking, JS, Crofts, N, Mijch, AM, Judd, FK (1997). HIV risk behaviour and HIV testing of psychiatric patients in Melbourne. Australian and New Zealand Journal of Psychiatry 31, 566576.CrossRefGoogle ScholarPubMed
Tucker, JS, Kanouse, DE, Min, A, Koegel, P, Sullivan, G (2003). HIV risk behaviors and their correlates among HIV-positive adults with serious mental illness. AIDS and Behavior 7, 2940.CrossRefGoogle ScholarPubMed
Uldall, KK, Palmer, NB, Whetten, K, Mellins, C, for the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study Group (2004). Adherence in people living with HIV/AIDS, mental illness, and chemical dependency: a review of the literature. AIDS Care 16, S71S96.CrossRefGoogle ScholarPubMed
Walkup, J, McAlpine, DD, Olfson, M, Boyer, C, Hansell, S (2000). Recent HIV testing among general hospital inpatients with schizophrenia: findings from four New York City sites. Psychiatric Quarterly 71, 177193.CrossRefGoogle ScholarPubMed
Walkup, J, Satriano, J, Berry, D, Sadler, P, Cournos, F (2002). HIV testing policy and serious mental illness. American Journal of Public Health 92, 19311939.CrossRefGoogle ScholarPubMed
Walkup, J, Satriano, J, Hansell, S, Olfson, M (1998). Practices related to HIV risk assessment in general hospital psychiatric units in New York state. Psychiatric Services 49, 529530.CrossRefGoogle ScholarPubMed
Weinhardt, LS, Carey, MP, Carey, KB (1998). HIV-risk behavior and the public health context of HIV/AIDS among women living with a severe and persistent mental illness. Journal of Nervous and Mental Disease 186, 276282.CrossRefGoogle ScholarPubMed
Weinhardt, LS, Carey, MP, Johnson, BT, Bickham, NL (1999). Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. American Journal of Public Health 89, 13971405.CrossRefGoogle ScholarPubMed
Weinhardt, LS, Otto-Salaj, LL, Brondino, MJ, Norberg, MM, Kalichman, SC (2002). Sex-related alcohol expectancies predict sexual risk behavior among severely and persistently mentally ill adults. Psychology of Addictive Behaviors 16, 6467.CrossRefGoogle ScholarPubMed