TY - JOUR
T1 - Human immunodeficiency virus diagnosis and care among adults with intellectual and developmental disabilities who are publicly insured
AU - James, T. G.
AU - Argenyi, M. S.
AU - Gravino, A.
AU - Benevides, T. W.
N1 - Publisher Copyright:
© 2023 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
PY - 2024/2
Y1 - 2024/2
N2 - Background: This study aimed to assess the prevalence of human immunodeficiency virus (HIV) testing, HIV diagnosis and receipt of HIV care among adults with intellectual and developmental disabilities (IDDs) who are publicly insured in the USA. Design: This study is a cross-sectional analysis of Medicare–Medicaid linked data of adults with IDD who were publicly insured in 2012 (n = 878 186). Methods: We estimated adjusted prevalence ratios of HIV testing, diagnosis and receipt of antiretroviral therapy (ART). We also identified the relationship between predisposing (age, gender, race and ethnicity), enabling (Medicare, Medicaid or both; rural status; geographical location; and county income) and need-related characteristics (IDD diagnosis and other co-occurring conditions) associated with these outcomes. Results: Only 0.12% of adults with IDD who had no known HIV diagnosis had received an HIV test in the past year. The prevalence of HIV diagnosis among adults with IDD was 0.38%, although differences by type of IDD diagnosis were observed. Prevalence of HIV diagnosis differed by type of IDD. Among adults with IDD who were living with HIV, approximately 71% had received ART during 2012. The adjusted analyses indicate significant racial disparities, with Black adults with IDD making up the majority (59.11%) of the HIV-positive IDD adult population. Conclusions: Adults with IDD are a unique priority population at risk for HIV-related disparities, and the level of risk is differential among subtypes of IDD. People with IDD, like other people with disabilities, should be considered in prevention programming and treatment guidelines to address disparities across the HIV care continuum.
AB - Background: This study aimed to assess the prevalence of human immunodeficiency virus (HIV) testing, HIV diagnosis and receipt of HIV care among adults with intellectual and developmental disabilities (IDDs) who are publicly insured in the USA. Design: This study is a cross-sectional analysis of Medicare–Medicaid linked data of adults with IDD who were publicly insured in 2012 (n = 878 186). Methods: We estimated adjusted prevalence ratios of HIV testing, diagnosis and receipt of antiretroviral therapy (ART). We also identified the relationship between predisposing (age, gender, race and ethnicity), enabling (Medicare, Medicaid or both; rural status; geographical location; and county income) and need-related characteristics (IDD diagnosis and other co-occurring conditions) associated with these outcomes. Results: Only 0.12% of adults with IDD who had no known HIV diagnosis had received an HIV test in the past year. The prevalence of HIV diagnosis among adults with IDD was 0.38%, although differences by type of IDD diagnosis were observed. Prevalence of HIV diagnosis differed by type of IDD. Among adults with IDD who were living with HIV, approximately 71% had received ART during 2012. The adjusted analyses indicate significant racial disparities, with Black adults with IDD making up the majority (59.11%) of the HIV-positive IDD adult population. Conclusions: Adults with IDD are a unique priority population at risk for HIV-related disparities, and the level of risk is differential among subtypes of IDD. People with IDD, like other people with disabilities, should be considered in prevention programming and treatment guidelines to address disparities across the HIV care continuum.
KW - HIV
KW - developmental disabilities
KW - healthcare disparities
KW - intellectual disability
KW - medical assistance (Medicare/Medicaid)
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U2 - 10.1111/jir.13099
DO - 10.1111/jir.13099
M3 - Article
C2 - 37859301
AN - SCOPUS:85174319904
SN - 0964-2633
VL - 68
SP - 150
EP - 163
JO - Journal of Intellectual Disability Research
JF - Journal of Intellectual Disability Research
IS - 2
ER -