HIV Testing and Prevention

Psychiatric illness is associated with increased likelihood of infection with HIV, and thus patients living with psychiatric illness represent a population that is particularly vulnerable to new HIV infection. Clinicians who work with patients with psychiatric illness and other patients at high risk for HIV have the opportunity and responsibility to intervene with screening, prevention, and other measures to reduce the burden of HIV-related illness in these patients. In this chapter, we review concepts in HIV prevention that are relevant to patients with psychiatric illness. We first discuss some of the core strategies in public health approaches to HIV prevention, including treatment as prevention (TasP), pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP.) We then review some of the factors that place psychiatrically ill people at particularly high risk for HIV. Finally, we discuss specific recommendations for assessment, testing, and providing PrEP and PEP to patients with psychiatric illness.