HIV Testing in Psychiatric Patients in Brazil

BACKGROUND There is evidence that a high proportion of people living with HIV infection are unaware of their serologic status, which indicates unmet prevention needs. The aim of the present study was to estimate the rate of lifetime HIV testing and assess the association between previous HIV testing and sociodemographic, clinical characteristics, and risk behaviors in psychiatric patients. METHODS Cross-sectional national multicenter study including 2380 chronic mentally ill patients randomly selected from 26 Brazilian mental health institutions. Multivariate logistic regression analysis was used to describe the association between patient characteristics and previous HIV testing. RESULTS The rate of previous lifetime HIV testing was 27%. Most participants were female (52%), 40 years old or younger (52%) with low schooling (59%), and had previous psychiatric hospitalizations (57%) and schizophrenia as a primary condition (48%). Being tested for HIV was independently associated (P < 0.05) in the multivariate analysis with higher schooling, being younger than 40 years old, living alone, having other self-reported medical conditions, higher HIV/AIDS knowledge, substance use as a main psychiatric condition, a history of sexually transmitted diseases, sexual abuse, and inconsistent lifetime condom use. However, those who never had sexual intercourse and did not know their HIV risk were less likely to be tested. CONCLUSIONS The rate of HIV testing among these psychiatric patients was low despite their increased risk for HIV infection. These findings support the need for increasing HIV testing and awareness of HIV status among psychiatric patients. Mental health providers should play an active role in providing HIV testing and counseling to this population.