Klinkenberg W Dean, Caslyn Robert J, Morse Gary A, Yonker Robert D, McCudden Suzanne, Ketema Fassil, Constantine Niel T
Missouri Institute of Mental Health, University of Missouri School of Medicine, St Louis 63139, USA.
Compr Psychiatry. 2003 Jul-Aug;44(4):293-302. doi: 10.1016/S0010-440X(03)00094-4.
This study was undertaken to determine the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among homeless persons with co-occurring severe mental illness (SMI) and substance use disorders and to determine associated risk factors. As part of a longitudinal study of the effectiveness of integrated treatment for homeless persons with SMI and substance abuse or dependence, serological testing was performed to ascertain the prevalence of HIV, HBV, and HCV. At baseline, 6.2% of participants (11/172) were HIV-positive. Nearly one third of participants (37/114) had evidence of prior exposure to HBV, and 30% (34/114) were antibody positive for HCV. About 44% of participants (50/114) had a reactive test for either HBV or HCV. Having a reactive test was strongly associated with substance use, especially with a history of injection drug use. A significant threat exists to the health and well-being of homeless person with SMI due to high prevalence of blood-borne pathogens. Mental health providers need to play a proactive role in the identification of health-related needs and to assist with access to general health services for persons with SMI.
本研究旨在确定同时患有严重精神疾病（SMI）和物质使用障碍的无家可归者中人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的流行情况，并确定相关风险因素。作为对患有SMI和物质滥用或依赖的无家可归者进行综合治疗效果的纵向研究的一部分，进行了血清学检测以确定HIV、HBV和HCV的流行情况。在基线时，6.2%的参与者（11/172）HIV呈阳性。近三分之一的参与者（37/114）有既往接触HBV的证据，30%（34/114）HCV抗体呈阳性。约44%的参与者（50/114）HBV或HCV检测呈阳性。检测呈阳性与物质使用密切相关，尤其是有注射吸毒史。由于血源性病原体的高流行率，患有SMI的无家可归者的健康和福祉面临重大威胁。心理健康提供者需要在识别与健康相关的需求方面发挥积极作用，并协助患有SMI的人获得一般医疗服务。
