Prevalence of HIV in mental health service users: a retrospective cohort study

Heslin, Margaret; Jewell, Amelia; Croxford, Sara; Chau, Cuong; Smith, Shubulade; Pittrof, Rudiger; Covshoff, Elana; Sullivan, Ann; Delpech, Valerie; Brown, Alison; King, Helena P; Kakaiya, Mina; Campbell, Lucy; Hughes, Liz; Stewart, Robert

Abstract

Objective: To examine the prevalence of Human Immunodeficiency Virus (HIV) in a cohort of people who have used secondary mental health services in the UK.
Design: Retrospective cohort study.
Setting: Routinely collected clinical data from secondary mental health services in South London, UK available for research through the Clinical Record Interactive Search tool (CRIS) at the NIHR Maudsley Biomedical Research Centre (BRC) were matched with pseudonymised national HIV surveillance data held by the UK Health Security Agency (UKHSA) using a deterministic matching algorithm.
Participants: All adults aged 16+ who presented for the first time to mental health services in the South London and Maudsley (SLaM) NHS Trust between 1st January 2007 and 31st December 2018 were included.
Primary outcome: Point prevalence of HIV.
Results: There were 181,177 people who had contact with mental health services for the first time between 2007-2018 in SLaM. Overall, 2.47% (n=4,481) of those had a recorded HIV diagnosis in national HIV surveillance data at any time (before, during or after contact with mental health services), 24.73 people per 1,000. HIV point prevalence was highest in people with a diagnosed substance use disorder at 3.77% (n=784). A substantial percentage of the sample did not have a formal mental health diagnosis (27%), but even with those excluded, the point prevalence remained high at 2.31%. Around two-thirds of people had their diagnosis of HIV before contact with mental health services (67%; n=1,495).
Conclusions: The prevalence of HIV in people who have had contact with mental health services was approximately 2.5 times higher than the general population in the same geographical area. Future work should investigate risk factors and disparities in HIV outcomes between those with and without mental health service contact.

Citation

Heslin, M., Jewell, A., Croxford, S., Chau, C., Smith, S., Pittrof, R., …Stewart, R. (2023). Prevalence of HIV in mental health service users: a retrospective cohort study. BMJ Open, 13(4), Article e067337. https://doi.org/10.1136/+bmjopen-2022-067337

• Journal Article Type: Article
• Acceptance Date: Mar 1, 2023
• Online Publication Date: Apr 25, 2023
• Publication Date: 2023-04
• Deposit Date: Mar 1, 2023
• Publicly Available Date: May 3, 2023
• Print ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 4
• Article Number: e067337
• DOI: https://doi.org/10.1136/+bmjopen-2022-067337