Human immunodeficiency virus diagnosis and care among adults with intellectual and developmental disabilities who are publicly insured.

The data are from 2012, so current insurance, treatment options and HIV testing practice may differ. Only fee-for-service Medicare and Medicaid claims were included, and managed care plans were excluded, which the paper reports as 5.5% of the available adult sample in 2012. The study counted people with HIV diagnosis claims, not undiagnosed HIV, so testing and diagnosis rates may not capture everyone. Receipt of care was measured only by antiretroviral medication fills, not by viral load or CD4 tests. Because this is a cross-sectional claims study, it can describe differences among groups but cannot show what caused them. Adults with intellectual and developmental disabilities were included only if their claims had a qualifying diagnosis, so people without that coded diagnosis were missed. Some cases of HIV may have come from vertical transmission, but the data could not confirm this for all cases. Race and ethnicity had missing data (11.8%), and rural status also had missing data (2.4%).

The authors reported no conflicts of interest or commitments to disclose, except that one author has performed significant work with populations with intellectual and developmental disabilities. The funder had no role in design, analysis, interpretation or writing.

Do not read the lower testing and medication receipt among adults with autism and intellectual disability as proof that their disability causes these outcomes. The study used 2012 insurance claims and can only describe associations, not causes.