Increasing HIV Testing in Inpatient Psychiatry

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Psychiatric Services Research

Background:

• Individuals with serious mental illness (SMI) face higher risks of HIV infection.
• Regular HIV testing is infrequent among individuals with SMI, despite opportunities during psychiatric admissions.

Purpose of the Study:

• To evaluate the effectiveness of sequential interventions aimed at increasing HIV testing rates within an inpatient psychiatric setting.
• To assess the impact of administrative advocacy, on-site counseling, and clinician champions on HIV testing uptake.

Main Methods:

• Retrospective analysis of 11,360 inpatient psychiatric admissions from 2006-2012.
• Utilized general estimating equation methods to examine relationships between interventions, patient demographics, length of stay, and HIV test receipt.

Main Results:

• HIV testing increased from 7.2% to 30.3% over the study period, a five-fold rise.
• On-site HIV counseling intervention showed the largest increase in testing rates (25.1%).
• Shorter inpatient stays and certain racial/ethnic groups were associated with lower testing rates; 1.6% of tests were positive.

Conclusions:

• Sequential interventions can substantially improve HIV testing in psychiatric inpatients.
• Despite improvements, a significant majority of patients were not tested, highlighting the need for sustained interventions.
• Further strategies are required to optimize HIV screening within inpatient psychiatric services.