HIV sero-positivity in recently admitted and long-term psychiatric in-patients : prevalence and diagnostic profile

Abstract

OBJECTIVE: Research on HIV in South Africa has not reflected the impact of the disease on psychiatric patients. The aims of the study were: to compare the HIV prevalence among patient groups in Weskoppies Hospital; to compare psychiatric diagnoses of infected and non-infected patients; to assess intravenous drug use and high-risk sexual behaviour; to establish HIV-syphilis association; and to investigate the rapid test performance for screening, compared to the confirmatory ELISA test. METHOD: Onehundred- and-ninety-five patients were grouped into four categories according to their duration of admission and gender. HIV rapid testing, HIV ELISA, syphilis-RPR and TPHA testing were performed. RESULTS: The HIV prevalence of 11% in the sample was significantly associated with ‘gender-and-duration-of-admission’ categories (p=0.003). No significant association between HIV infection and psychiatric diagnoses or intravenous drug use was found, but a significant association existed between HIV infection and high-risk sexual behaviour (p=0.002), and between HIV and syphilis (p=0.012). The HIV rapid screening test had a sensitivity of 91.7% and a specificity of 98.2%. CONCLUSION: The overall HIV prevalence at Weskoppies Hospital remains lower than the national average, but has increased since a previous local study. The rapid test for HIV had a lower sensitivity than was expected, and it is recommended that HIV ELISA testing be performed as a first line test in the setting of hospitalised patients. Due to the high prevalence of HIV and syphilis in the psychiatric population it is recommended that all patients be tested for both of these diseases.