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患有精神疾病的成年人中艾滋病毒、梅毒、乙型肝炎和丙型肝炎的患病率:巴西的一项多中心研究。

Prevalence of HIV, syphilis, hepatitis B and C among adults with mental illness: a multicenter study in Brazil.

作者信息

Guimarães Mark Drew Crosland, Campos Lorenza Nogueira, Melo Ana Paula Souto, Carmo Ricardo Andrade, Machado Carla Jorge, Acurcio Francisco de Assis

机构信息

Department of Preventive and Social Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Braz J Psychiatry. 2009 Mar;31(1):43-7. doi: 10.1590/s1516-44462009000100011.

Abstract

OBJECTIVE

There is evidence that patients with mental illness have increased prevalence of sexually transmitted infections, but data in Brazil are scarce. The objective of this study was to determine the prevalence of HIV, hepatitis C and B, and syphilis among patients with mental illness in Brazil.

METHOD

A multicenter representative sample of adults with mental illness was randomly selected from 26 mental health institutions throughout Brazil. Sociodemographic, sexual behavior and clinical data were obtained from person-to-person interviews and blood was collected for serology testing. Seroprevalence with 95% confidence limits were obtained correcting for sampling scheme.

RESULTS

Of the 2,475 patients interviewed, 2,238 had blood collected. Most participants were sexually active ever (88.8%) or in the last 6 months (61.6%), female (51.9%), and single (66.6%). Half of the sample had less than 5 years of schooling and the mean monthly individual income was low (US$ 210.00). Condom use was very low either during lifetime (8%) or in the last 6 months (16%). Overall seroprevalence were 1.12%, 0.80%, 1.64%, 14.7% and 2.63% for, respectively, syphilis, HIV, HBsAg, anti-HBc and anti-HCV.

CONCLUSIONS

Seroprevalences found were higher than other populations with representative studies in Brazil, with high rates of sexual risk behavior. This is of public health concern, and prevention and care strategies for sexually transmitted infections among psychiatric patients should urgently be implemented by health authorities.

摘要

目的

有证据表明,精神疾病患者的性传播感染患病率有所上升,但巴西的相关数据较少。本研究的目的是确定巴西精神疾病患者中艾滋病毒、丙型和乙型肝炎以及梅毒的患病率。

方法

从巴西各地26家精神卫生机构中随机选取患有精神疾病的成年患者作为多中心代表性样本。通过面对面访谈获取社会人口统计学、性行为和临床数据,并采集血液进行血清学检测。针对抽样方案进行校正后得出95%置信区间的血清阳性率。

结果

在接受访谈的2475名患者中,2238人采集了血液样本。大多数参与者曾有过性活动(88.8%)或在过去6个月内有过性活动(61.6%),女性占51.9%,单身占66.6%。样本中有一半受教育年限不足5年,平均月个人收入较低(210.00美元)。终身使用避孕套的比例很低(8%),过去6个月内使用避孕套的比例也很低(16%)。梅毒、艾滋病毒、乙肝表面抗原、乙肝核心抗体和丙肝抗体的总体血清阳性率分别为1.12%、0.80%、1.64%、14.7%和2.63%。

结论

在巴西具有代表性的研究中,所发现的血清阳性率高于其他人群,且性行为风险行为发生率较高。这引起了公共卫生方面的关注,卫生当局应紧急实施针对精神科患者性传播感染的预防和护理策略。

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