title: Health profiles and associated service use among adults with HIV and intellectual and developmental disabilities.
abstract: Owing to the commonly held notion that individuals with intellectual and developmental disabilities (IDD) have low risk of HIV acquisition, we compared the prevalence of HIV infection among people with and without IDD. We also examined health status and health service use among the HIV-infected group.
  
  
  
  Population-based cohort study using linked administrative health and social services databases.
  
  
  
  We compared HIV prevalence between Ontario adults with IDD (n = 64 008) and a 20% random sample of Ontario adults without IDD. Among the HIV-infected group, we compared adults with and without IDD in terms of comorbid chronic physical conditions and mental health disorders, as well as use of overall health services, mental health services, and HIV-specific services.
  
  
  
  HIV prevalence per 100 000 population did not differ for adults with IDD [163.38 (95% confidence interval: 132.27, 199.6)] and without IDD [172.45 (95 confidence interval: 167.48, 177.53)]. Among the HIV-infected group, those with IDD had more comorbid chronic physical conditions and mental health disorders. They also had greater use of overall health services and mental health services. Likelihood of use of HIV-specific services also differed for those with and without IDD.
  
  
  
  A similar prevalence of HIV among adults with and without IDD accentuates a need for strategies for individuals with IDD to be included in HIV prevention efforts. High prevalence of chronic physical and mental health comorbidity and health service use among the HIV-infected group with IDD highlight a need for comprehensive and coordinated treatment plans to optimize outcomes for this complex patient group.
authors.affiliation: aCentre for Addiction and Mental Health bDepartment of Psychiatry, University of Toronto cInstitute for Clinical Evaluative Sciences dResearch and Evaluation, Canadian Mental Health Association (CMHA) eDalla Lana School of Public Health, University of Toronto fDepartment of Anthropology (Health Studies Program), University of Toronto Scarborough gWomen's College Research Institute, Women's College Hospital hDepartment of Family and Community Medicine iLi Ka Shing Knowledge Institute, St. Michael's Hospital jDepartment of Family and Community Medicine, University of Toronto, Toronto, Canada.
authors.forename: Yona
authors.initials: Y
authors.lastname: Lunsky
authors.forename: Anna
authors.initials: A
authors.lastname: Durbin
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Brown
authors.forename: Symron
authors.initials: S
authors.lastname: Bansal
authors.forename: Marina
authors.initials: M
authors.lastname: Heifetz
authors.forename: Tony
authors.initials: T
authors.lastname: Antoniou
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000473:pathology; D006296:Health Services; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D055815:Young Adult