Kelly J A, Murphy D A, Bahr G R, Brasfield T L, Davis D R, Hauth A C, Morgan M G, Stevenson L Y, Eilers M K
Department of Psychiatry and Mental Health Sciences, Medical College of Wisconsin, Milwaukee 53226.
Am J Psychiatry. 1992 Jul;149(7):886-9. doi: 10.1176/ajp.149.7.886.
There is growing concern that chronic mentally ill adults living in the community have a high risk for HIV infection. The purpose of this study was to identify risk knowledge, high-risk behaviors, and risk-related encounters of chronic psychiatric outpatients.
Detailed information on high-risk behaviors and risk-related situations during the past 12 months was collected from 60 outpatients appearing for regular visits at inner-city community mental health clinics.
Of the 60 outpatients, 37 (62%) had been sexually active during the past year, and 42% of the men and 19% of the women reported multiple sexual contacts and infrequent use of condoms during intercourse. Assessments of the patients' knowledge of AIDS risks revealed substantial deficits in their practical understanding of AIDS and risk reduction measures. Although use of intravenous drugs was uncommon in this group, many subjects reported histories of 1) trading sex for money, drugs, or a place to stay, 2) coercion to engage in unwanted sex, 3) causal sexual encounters, and 4) sexual activity after use of drugs or intoxicants. Twenty percent of the subjects had met their sexual partners on the streets, in parks, or in other public places. One-third had been treated for sexually transmitted diseases other than AIDS.
These findings underscore the need for AIDS risk assessment, counseling, and prevention programs for the chronic mentally ill.
社区中慢性精神病成年患者感染艾滋病病毒的风险日益受到关注。本研究旨在确定慢性精神科门诊患者的风险知识、高危行为及与风险相关的接触情况。
从市中心社区精神卫生诊所前来定期就诊的60名门诊患者中收集过去12个月内高危行为及与风险相关情况的详细信息。
在这60名门诊患者中，37名（62%）在过去一年中有性活动，42%的男性和19%的女性报告有多个性伴侣且性交时很少使用避孕套。对患者艾滋病风险知识的评估显示，他们对艾滋病及风险降低措施的实际理解存在很大欠缺。尽管该组中静脉注射毒品的情况不常见，但许多受试者报告有以下经历：1）以性换取金钱、毒品或住处；2）被迫进行不情愿的性行为；3）随意性接触；4）吸毒或使用 intoxicants 后进行性活动。20%的受试者在街头、公园或其他公共场所结识性伴侣。三分之一的人曾接受过艾滋病以外的性传播疾病治疗。
这些发现强调了为慢性精神病患者开展艾滋病风险评估、咨询及预防项目的必要性。
