title: Needs among persons with human immunodeficiency virus and intellectual and developmental disabilities in community mental health care: a cross-sectional study.
abstract: The experience of having human immunodeficiency virus (HIV) is often associated with co-occurring mental health issues. Community mental health services are an important source of support for persons with HIV living in the community. Persons with intellectual disability (ID) are vulnerable to HIV and may have unique support needs beyond those without ID receiving community care. This study compared support needs of men with HIV in community mental health programmes, with and without ID.
  
  
  
  The sample was composed of 138 HIV-positive men with and without ID receiving mental health case management from one community organisation in Ontario, Canada, on 31 March 2013. Staff-rated needs across 16 domains grouped into four clusters were measured using the Camberwell Assessment of Need: Basic needs (accommodation, food, public transportation, money and benefits); self-care/functional needs (looking after the home, self-care and daytime activities); health/safety needs (physical health, psychological distress, psychotic symptoms, safety to self and safety to others); and social needs (company, intimate relationships and sexual expression). Adjusted logistic regression models examined the association between ID and each need domain.
  
  
  
  One-quarter of the sample (n = 34/138, 24.6%) had co-occurring ID. Those with ID were more likely to have needs in the basic cluster [odds ratios: food 4.05 (1.14, 14.44), P:0.031; benefits 2.58 (1.05, 6.32), P:0.038)] and self-care/functional cluster [looking after the home (2.75 (1.17, 6.49), P:0.021); self-care (2.72 (1.18, 6.27), P:0.019)], but were less likely to have need for sexual expression: 0.35 (0.14,0.90), P:0.030) (social cluster). There were no differences in the domains in the health/safety cluster.
  
  
  
  Despite elevated cognitive needs in the basic and self-care/functional clusters for the ID group, limited other differences suggest that with moderate additional targeting, community mental health programmes for persons with HIV may be appropriate for men with ID.
authors: Department of Research and Evaluation, Canadian Mental Health Association-Toronto Branch (CMHA), Toronto, Ontario, Canada.
authors: A
authors: A
authors: Durbin
authors: Department of Research and Evaluation, Canadian Mental Health Association-Toronto Branch (CMHA), Toronto, Ontario, Canada.|Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
authors: F
authors: F
authors: Sirotich
authors: Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.|Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Y
authors: Y
authors: Lunsky
authors: LOFT Community Services/McEwan Housing and Support Services, Toronto, Ontario, Canada.
authors: K
authors: K
authors: Roesslein
authors: Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.|Performance Measurement and Evaluation Research, Provincial System and Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: J
authors: J
authors: Durbin
mesh_terms: D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000379:methods*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology / Q000534:rehabilitation*; D015658:HIV Infections / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D020380:Needs Assessment; D009864:Ontario; D055815:Young Adult
keywords: AIDS; HIV; ID; community care; mental health; needs