How HIV affects health and service use for adults with intellectual and developmental disabilities.

Autor: Durbin A; Epidemiology Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.; Research and Evaluation, Canadian Mental Health Association - Toronto Branch (CMHA), Toronto, Ontario, Canada., Brown HK; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Anthropology (Health Studies Program), University of Toronto Scarborough, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada., Bansal S; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada., Antoniou T; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada., Jung JKH; Epidemiology Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Lunsky Y; Epidemiology Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Journal of intellectual disability research : JIDR [J Intellect Disabil Res] 2017 Jul; Vol. 61 (7), pp. 682-696.
DOI: 10.1111/jir.12381
Abstrakt: Objective(s): Although rates of human immunodeficiency virus (HIV) are similar for individuals with and without intellectual and developmental disabilities (IDD), very little is known about the health needs and service use of those with IDD and HIV. Among a population with IDD, we compared the physical and mental health profiles, as well as general and mental health service use for those with and without HIV.
Design: Retrospective cohort study in Ontario, Canada using linked administrative health and social service databases.
Methods: The prevalence of physical conditions and mental health disorders, and patterns of service use for any reason and service use for mental health issues were compared among Ontario adults with IDD and HIV (n = 107) and without HIV (n = 63 901) in log-binomial models adjusted for age, sex and neighbourhood income and rurality.
Results: Adults with IDD and HIV were more likely than those without HIV to have three types of mental health disorders: non-psychotic disorders [aRR: adjusted rate ratio (aRR): 1.22 (95% confidence interval (CI): 1.01-1.47)], psychotic disorders [aRR: 1.57 (1.09, 2.28)] and substance use disorders [aRR: 3.52 (2.53, 4.91)]. Adults with IDD and HIV were also more likely to have emergency department visits [aRR: 1.68 (1.42, 1.98)] and hospital admissions [aRR: 2.55 (1.74, 3.73)] for any reason, and to have mental health emergency department visits and/or admissions [aRR: 2.82 (1.90, 4.18)].
Discussion: Adults with IDD and HIV have complex health profiles and greater health service use than HIV-negative adults with IDD. These findings call for closer integration of programs delivered by the HIV and disability sectors to optimise the health of this patient population.
(© 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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