Assessing HIV Screening among Adolescents and Adults with Mental Illness in a Rural Health Setting

Abstract

Current Center for Disease Control and Prevention (CDC) recommendations are for one-time Human Immunodeficiency Virus (HIV) screening for all people age 13-64. Studies have demonstrated the psychiatric population is at increased risk for HIV with a prevalence of 3-8% compared to the general population at 0.6%. For these reasons, a retrospective chart review was performed, looking at the rate of HIV testing for psychiatric patients at Bay Clinic, a rural private clinic in Coos Bay, Oregon. Charts were reviewed on 450 consecutive patients seen by three different providers from December 1, 2017 to June 30, 2018. In total, 373 patients met inclusion criteria, specifically, patients had to be between age 13-64 and have a psychiatric diagnosis in their medical record. Of these patients only 27 (7.1%) had received formal HIV testing with similar testing rates amongst all three providers. A provider survey was sent out to three providers, including one Psychiatric Mental Health Nurse Practitioner and two-Family Nurse Practitioners, to assess barriers and facilitators to HIV testing, as well as what is needed to enhance screening. A lack of provider education regarding current CDC recommendations on HIV testing was found. An educational PowerPoint presentation was created and sent to providers, to help improve compliance with CDC guidelines for HIV testing, with a recommendation for implementation of a question regarding HIV testing as part of nursing/medical assistant intake for all patients. A future study could be carried out to examine the effectiveness of this intervention.