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How HIV affects health and service use for adults with intellectual and developmental disabilities
Author(s) -
Durbin A.,
Brown H. K.,
Bansal S.,
Antoniou T.,
Jung J. K. H.,
Lunsky Y.
Publication year - 2017
Publication title -
journal of intellectual disability research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.941
H-Index - 104
eISSN - 1365-2788
pISSN - 0964-2633
DOI - 10.1111/jir.12381
Subject(s) - mental health , medicine , population , intellectual disability , psychiatry , cohort study , relative risk , gerontology , confidence interval , environmental health , pathology
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.