Health Services Research & Development

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2006 HSR&D National Meeting Abstract


1070 — HIV Testing, Receipt of Results, and Post-Test Counseling among Veterans with Serious Mental Illness

Author List:
Desai MM (Northeast Program Evaluation Center)
Rosenheck RA (Northeast Program Evaluation Center)
Desai RA (Northeast Program Evaluation Center)

Objectives:
Persons with serious mental illness (SMI) are at increased risk for HIV infection. With seroprevalence rates of >=1%, persons with SMI represent a population for whom HIV testing should be routinely recommended, according to CDC guidelines. Moreover, post-test counseling sessions provide valuable opportunities for HIV education and risk-reduction counseling, even for those whose test results are negative. The objectives of this study were to determine the prevalence and correlates of HIV testing, receipt of results, and post-test counseling among VA and non-VA patients with SMI.

Methods:
Random samples of outpatients with SMI were interviewed at the VA Connecticut Healthcare System in West Haven (n=196) and two community mental health centers in New Haven (n=190) and Bridgeport (n=147) between 1996-97. All subjects were male, aged >=18 years, and had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder.

Results:
Overall, 56.0% of the VA sample reported ever having been tested for HIV, similar to the proportion found in the non-VA sample (62.2%; p=0.17). Of particular concern, however, was the finding that only two-thirds of those who reported being “very afraid” of getting AIDS had been previously tested. Using multivariate logistic regression, we found that prior HIV testing was significantly associated with younger age, history of STD, comorbid medical conditions, increased drug problems, and criminal history. Among those tested, nearly all reported receiving their HIV test results (97.2% of the VA sample and 94.9% of the non-VA sample, p=0.55); however, only 39.6% of the VA sample reported receiving any post-test counseling, compared with 56.2% of the non-VA sample (p=0.007).

Implications:
Although the majority of VA patients with SMI had been tested for HIV at least once, a substantial proportion of those with self-perceived risk had not. Moreover, the vast majority of those who had been tested never received important post-test counseling.

Impacts:
The findings of this study will help to enhance the development and targeting of strategies to increase HIV testing and counseling among veterans with SMI.