title: Correlates of HIV infection among patients with mental illness in Brazil.
abstract: People living with mental illness are at increased risk for HIV. There are scarce data on correlates and prevalence of HIV infection, and none with a nationally representative sample. We report on correlates of HIV infection from a cross-sectional national sample of adults receiving care in 26 publicly funded mental health treatment settings throughout Brazil. Weighted prevalence rate ratios were obtained using multiple log-binomial regression modeling. History of homelessness, ever having an STD, early age of first sexual intercourse before 18 years old, having suffered sexual violence, previous HIV testing, self-perception of high risk of HIV infection and not knowing one's risk were statistically associated with HIV infection. Our study found an elevated HIV seroprevalence and correlates of infection were not found to include psychiatric diagnoses or hospitalizations but instead reflected marginalized living circumstances and HIV testing history. These adverse life circumstances (history of homelessness, having suffered sexual violence, reporting a sexually transmitted disease, and early sexual debut) may not be unique to people living with mental illness but nonetheless the mental health care system can serve as an important point of entry for HIV prevention in this population.
authors.affiliation: a Department of Preventive and Social Medicine, School of Medicine , Federal University of Minas Gerais , Belo Horizonte , Brazil.
authors.forename: Mark D C
authors.initials: MD
authors.lastname: Guimarães
authors.forename: Karen
authors.initials: K
authors.lastname: McKinnon
authors.forename: Francine
authors.initials: F
authors.lastname: Cournos
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Machado
authors.forename: Ana Paula S
authors.initials: AP
authors.lastname: Melo
authors.forename: Lorenza N
authors.initials: LN
authors.lastname: Campos
authors.forename: Milton L
authors.initials: ML
authors.lastname: Wainberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012649:Self Concept; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014754:Violence; D055815:Young Adult