Recorded presentation

Michael B Blank, PhD¹, Aileen Rothbard, ScD¹, David Metzger, PhD², and William Thompson, PhD³. (1) Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, 215-349-8488, mblank2@mail.med.upenn.edu, (2) Center for the Studies of Addiction, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA 19104, (3) Influenza Branch, Centers for Disease Control & Prevention, 1600 Clifton Road, Atlanta, GA 30333

The primary objective of this study was to establish estimates of the relative risk of receiving treatment for an opportunistic infection among treated persons in Philadelphia who received Medicaid reimbursed services over an eleven-year period. Subjects of the study included all adult Medicaid recipients between July, 1986, and June, 1997 (N = 611,725). Medicaid claims records were used both to identify diagnostic groups and to identify denominators of individuals who received treatment for one or more of the target conditions during the study period. Groups were designated based on those who received a diagnosis of severe mental illness, substance abuse, and/or HIV/AIDS. Those with none of the target conditions were used as controls. The results demonstrated a similar pattern for most OI's. Persons with all three conditions, (co-morbid SMI, SA, and HIV/AIDS) had the highest relative risk, followed by persons who were HIV positive and substance using. Rates of opportunistic infections that were also STD’s were especially high among co-morbid persons. Persons with only SMI or SA only were at greater risk than the general Medicaid population. We conclude that public health providers and policy makers should be aware of the increased risk for adverse health outcomes for persons with co-morbid HIV/AIDS, SMI, and SA. Additionally, preventive efforts should target those who are at increased risk, especially for STD’s. Logical loci for these interventions will be discussed.

Learning Objectives: At the conclusion of the session, the listener will be able to

• describe the relative risk of opportunistic infections among persons with HIV/AIDS, substance abuse, and mental illness,
• articulate potential mechansims by which increased risk is manifest in these groups, and
• plan for preventive interventions for OI's.

Keywords: HIV/AIDS, Mental Illness

Related Web page: www.uphs.upenn.edu/cmhpsr/

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation