Cournos F, Empfield M, Horwath E, McKinnon K, Meyer I, Schrage H, Currie C, Agosin B
New York State Psychiatric Institute, NY 10032.
Am J Psychiatry. 1991 Sep;148(9):1225-30. doi: 10.1176/ajp.148.9.1225.
The authors determined the seroprevalence of HIV-1 among patients admitted to two psychiatric hospitals in New York City.
Patients consecutively admitted to an acute psychiatric unit in Manhattan and a large state hospital in Queens were anonymously tested for HIV-1 antibodies from December 1989 through July 1990. Test results were linked to age, gender, ethnicity, and two risk behaviors: male homosexual activity and injection drug use.
Blood was obtained from 83.0% of the eligible patients. The prevalence of HIV was 5.5% (25 of 451). Black patients accounted for 38.0% of the patients tested and 76.0% of positive results (N = 19), a rate of 11.1% for this group. The rate of seropositivity was comparable in women and men. Clinicians had charted risk behavior for nine (36.0%) of the 25 HIV-positive patients. Infection control records suggested that clinicians were aware of seven (28.0%) of the positive cases.
One in every 18 patients admitted to two public psychiatric hospitals in New York City was HIV positive. Clinical staff largely failed to identify HIV-positive patients. Ethnicity and a history of homosexual activity among men or use of injected drugs were strongly associated with seropositivity. This pattern of infection may be linked to needle sharing and/or sexual activity with partners who have shared needles. Future research should clarify how psychiatric illness affects risk-taking behavior, focus on improving detection by clinicians, and identify effective prevention strategies in this population.
作者确定了纽约市两家精神病医院收治患者中HIV-1的血清流行率。
1989年12月至1990年7月期间，对连续入住曼哈顿一家急性精神病科和皇后区一家大型州立医院的患者进行了HIV-1抗体匿名检测。检测结果与年龄、性别、种族以及两种风险行为相关联：男性同性恋活动和注射吸毒。
83.0%的符合条件患者提供了血液样本。HIV的流行率为5.5%（451例中有25例）。黑人患者占检测患者的38.0%，阳性结果占76.0%（N = 19），该组的阳性率为11.1%。女性和男性的血清阳性率相当。临床医生记录了25例HIV阳性患者中9例（36.0%）的风险行为。感染控制记录显示临床医生知晓7例（28.0%）阳性病例。
纽约市两家公立精神病医院收治的患者中，每18人就有1人HIV呈阳性。临床工作人员在很大程度上未能识别出HIV阳性患者。种族以及男性同性恋活动史或注射吸毒史与血清阳性密切相关。这种感染模式可能与共用针头和/或与共用针头的性伴侣发生性行为有关。未来的研究应阐明精神疾病如何影响冒险行为，着重提高临床医生的检测能力，并确定针对该人群的有效预防策略。
