HIV seroprevalence among patients admitted to two psychiatric hospitals.
OBJECTIVE
The authors determined the seroprevalence of HIV-1 among patients admitted to two psychiatric hospitals in New York City.


METHODS
Patients consecutively admitted to an acute psychiatric unit in Manhattan and a large state hospital in Queens were anonymously tested for HIV-1 antibodies from December 1989 through July 1990. Test results were linked to age, gender, ethnicity, and two risk behaviors: male homosexual activity and injection drug use.


RESULTS
Blood was obtained from 83.0% of the eligible patients. The prevalence of HIV was 5.5% (25 of 451). Black patients accounted for 38.0% of the patients tested and 76.0% of positive results (N = 19), a rate of 11.1% for this group. The rate of seropositivity was comparable in women and men. Clinicians had charted risk behavior for nine (36.0%) of the 25 HIV-positive patients. Infection control records suggested that clinicians were aware of seven (28.0%) of the positive cases.


CONCLUSIONS
One in every 18 patients admitted to two public psychiatric hospitals in New York City was HIV positive. Clinical staff largely failed to identify HIV-positive patients. Ethnicity and a history of homosexual activity among men or use of injected drugs were strongly associated with seropositivity. This pattern of infection may be linked to needle sharing and/or sexual activity with partners who have shared needles. Future research should clarify how psychiatric illness affects risk-taking behavior, focus on improving detection by clinicians, and identify effective prevention strategies in this population.
Cournos
F
F
New York State Psychiatric Institute, NY 10032.
Empfield
M
M
Horwath
E
E
McKinnon
K
K
Meyer
I
I
Schrage
H
H
Currie
C
C
Agosin
B
B
D000293:Adolescent; D000328:Adult; D005006:Ethnicity; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015528:HIV Seroprevalence / Q000639:trends*; D006716:Homosexuality / Q000523:psychology; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011618:Psychotic Disorders / Q000150:complications; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology