title: Serious mental illness and risk of new HIV/AIDS diagnoses: an analysis of Medicaid beneficiaries in eight states.
abstract: OBJECTIVE
  A longitudinal analysis was used to explore the relationship between diagnosis of serious mental illness and subsequent new diagnoses of HIV.
  
  
  METHODS
  Logistic regression was used to predict HIV/AIDS diagnoses in 2002–2004 among Medicaid beneficiaries in eight states (N=6,417,676) who were without HIV in 2001. Results for beneficiaries with and without serious mental illness, a substance use disorder, and psychiatric comorbidities in 2001 were compared.
  
  
  RESULTS
  After controlling for substance abuse or dependence and other factors, the analyses indicated that the odds of new HIV/AIDS diagnoses among beneficiaries with or without serious mental illness did not differ significantly. Compared with beneficiaries without a substance use disorder or serious mental illness, individuals with a substance use disorder but without serious mental illness were 3.1 times (OR=3.13, p<.001) more likely, and those with both substance abuse or dependence and serious mental illness were 2.1 times (OR=2.09, p<.001) more likely, to receive a new HIV diagnosis in 2002–2004. However, people with serious mental illness but without a substance use disorder in 2001 were 23% less likely (OR=.77, p<.001) than people without serious mental illness or a substance use disorder in 2001 to receive a new HIV diagnosis.
  
  
  CONCLUSIONS
  After substance abuse or dependence was controlled for longitudinally, little independent association between serious mental illness and the risk of new HIV diagnoses was found. HIV-prevention services for low-income individuals should be delivered to all persons with serious mental illness, but especially those with comorbid substance use disorders.
authors.affiliation: Silberman School of Social Work at Hunter College, City University of New York, 2810 Third Ave., New York, NY 10035, USA. jprin@hunter.cuny.edu
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Prince
authors.forename: James
authors.initials: J
authors.lastname: Walkup
authors.forename: Ayse
authors.initials: A
authors.lastname: Akincigil
authors.forename: Shahla
authors.initials: S
authors.lastname: Amin
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult