The association of psychiatric disorders and HIV infection in the correctional setting.
OBJECTIVE
Psychiatric disorders, such as bipolar disorder, schizophrenia, and depression, have been associated with both HIV-associated risk behaviors and HIV infection. While the US prison population is reported to exhibit elevated rates of HIV/AIDS and most psychiatric disorders, scarce information currently exists on the association of these conditions in the prison setting. The present study examined the association of six major psychiatric disorders with HIV infection in one of the nation's largest prison populations.


METHODS
The study population consisted of 336,668 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 1999 and December 31, 2001. Information on medical conditions and sociodemographic factors was obtained from an institution-wide medical information system.


RESULTS
Inmates diagnosed with HIV infection exhibited elevated rates of major depression, dysthymia, bipolar disorder, schizophrenia, schizoaffective disorder, and non-schizophrenic psychotic disorder. These rates persisted in stratified analyses and in a multivariate analysis that statistically adjusted for gender, race, and age category.


CONCLUSIONS
The present cross-sectional study's finding of a positive association between HIV infection and psychiatric diagnoses among inmates holds both clinical and public health relevance. It will be important for future investigations to prospectively assess the underlying mechanisms of these associations in the correctional setting.
Baillargeon
Jacques
J
Center for Epidemiology and Biostatistics/Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX 78284-7802, USA. baillargeon@uthscsa.edu
Ducate
Suzanne
S
Pulvino
John
J
Bradshaw
Patrick
P
Murray
Owen
O
Olvera
Rene
R
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners; D013781:Texas / Q000453:epidemiology