Health profiles and associated service use among adults with HIV and intellectual and developmental disabilities

Objective(s) — Due to the commonly held notion that individuals with intellectual and developmental disabilities (IDD) have low risk of HIV acquisition, we compared the prevalence of HIV infection among people with and without IDD. We also examined health status and health service use among the HIV-infected group.

Design — Population-based cohort study using linked administrative health and social services databases.

Methods — We compared HIV prevalence between Ontario adults with IDD (n=64,008) and a 20% random sample of Ontario adults without IDD. Among the HIV-infected group, we compared adults with and without IDD in terms of comorbid chronic physical conditions and mental health (MH) disorders, as well as use of overall health services, MH services, and HIV-specific services.

Results — HIV prevalence per 100,000 population did not differ for adults with IDD [163.38 (95% CI: 132.27,199.6)] and without IDD [172.45 (95 CI: 167.48,177.53)]. Among the HIV-infected group, those with IDD had more comorbid chronic physical conditions and MH disorders. They also had greater use of overall health services and MH services. Likelihood of use of HIV-specific services also differed for those with and without IDD.

Discussion — A similar prevalence of HIV among adults with and without IDD accentuates a need for strategies for individuals with IDD to be included in HIV prevention efforts. High prevalence of chronic physical and MH comorbidity and health service use among the HIV infected group with IDD highlight a need for comprehensive and coordinated treatment plans to optimize outcomes for this complex patient group.