The risk of purified protein derivative positivity in homeless men with psychotic symptoms

Background. Homeless people with mental illness have relatively high rates of human immunodeficiency virus, comorbid antisocial personality disorder, and may be homeless more frequently and for greater lengths of time. All of these factors may increase the risk of tuberculosis. Methods. Our study was done to ascertain if homeless men with psychotic dis orders are at an increased risk for tuberculosis infection. One hundred fif ty homeless men were interviewed and given purified protein derivatives (PP Ds) at a downtown shelter in New Orleans, Louisiana, during a S-month perio d. Results. The findings show a strong relationship,between psychotic disorder s and positive PPDs, with a relative risk of 4.48. Conclusions. Homelessness and mental illness present barriers to seeking an d completing treatment for medical illnesses such as tuberculosis. Use of s ervices may be low even when available; therefore, homeless men with psycho tic disorders may be serving as a reservoir for tuberculosis.