Low Rates of HIV Testing Among Adults With Severe Mental Illness Receiving Care in Community Mental Health Settings.

Objective: This research aimed to characterize HIV testing rates among Medicaid recipients with severe mental illness who received public specialty mental health services.

Methods: This retrospective cohort study examined California Medicaid records from October 1, 2010, to September 30, 2011 (N=56,895). Study participants were between age 18 and 67, utilized specialty mental health care services, were prescribed antipsychotic medications, and were not dually eligible for Medicare. Adjusted Poisson regression models were used to estimate the overall effects of predictor variables on HIV testing prevalence.

Results: During the study period, 6.7% of people with severe mental illness received HIV testing. Men were 32% less likely to be tested for HIV than women (p<.001). Compared with whites, Asians/Pacific Islanders were 53% less likely and blacks were 82% more likely to be tested (p<.001). Those with comorbid drug or alcohol use disorders were more likely to be tested than those without such disorders (p<.001). Utilization of nonpsychiatric medical care was the strongest predictor of HIV testing (p<.001).

Conclusions: Most adults with severe mental illness receiving public specialty mental health services were not tested for HIV during a one-year period. Public health administrators must prioritize HIV testing for early identification of HIV infection and prevention of HIV transmission.