Format

Send to

Choose Destination
Psychosomatics. 2018 Mar - Apr;59(2):186-192. doi: 10.1016/j.psym.2017.10.007. Epub 2017 Oct 23.

Increasing HIV Testing in Inpatient Psychiatry.

Author information

1
Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA. Electronic address: martha.shumway@ucsf.edu.
2
Department of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences and Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA.
3
San Francisco Department of Public Health, San Francisco, CA.
4
Department of Clinical Pharmacy, University of California San Francisco Medical Center, San Francisco, CA.

Abstract

BACKGROUND:

People with serious mental illness (SMI) are at elevated risk of HIV infection, but do not receive HIV tests regularly. Inpatient psychiatric admissions provide opportunities for HIV testing.

OBJECTIVE:

This study retrospectively examined the impact of three sequential interventions designed to increase HIV testing on an acute inpatient psychiatry service: (1) advocacy by an administrative champion, (2) an on-site HIV counselor, and (3) a clinician championing HIV testing.

METHOD:

Demographic and HIV testing data were extracted from hospital data systems for 11,360 admissions of HIV-negative patients to an inpatient psychiatry service between 2006 and 2012. Relationships among interventions, length of stay, patient demographics, and receipt of an HIV test were examined using general estimating equation methods.

RESULTS:

In the year prior to the intervention, 7.2% of psychiatric inpatients received HIV tests. After 1 year of administrative advocacy, 11.2% received tests. Following the HIV counseling intervention, 25.1% of patients were tested. After the counseling intervention ended, continued administrative and clinical advocacy was associated with further increases in testing. In the final year studied, 30.3% of patients received HIV tests. Patients with shorter inpatient stays and those of Black or Asian race/ethnicity were less likely to be tested. Further, 1.6% of HIV tests were positive.

CONCLUSION:

Three interventions of varying intensity were associated with a 5-fold increase in HIV testing on an acute inpatient psychiatry service. Nonetheless, 70% of inpatients were not tested. Continued efforts are needed to increase HIV testing in inpatient psychiatric settings.

KEYWORDS:

HIV testing; inpatient; psychiatry; serious mental illness.

PMID:
29153630
PMCID:
PMC5857211
[Available on 2019-03-01]
DOI:
10.1016/j.psym.2017.10.007

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center