Walsh Chloe, McCann Edward, Gilbody Simon, Hughes Elizabeth
Hull and East Yorkshire Hospitals NHS Trust, UK.
Int J Ment Health Nurs. 2014 Aug;23(4):344-54. doi: 10.1111/inm.12065. Epub 2014 Mar 13.
People diagnosed with severe mental illness (SMI) are at greater risk of HIV than the general population. However, little attention has been given to how best to reduce sexual risk taking in this group. The aim of the review was to evaluate the effectiveness of behavioural interventions to promote sexual safety behaviour in people diagnosed with SMI. A comprehensive search of relevant databases was undertaken, and studies were included if they were randomized, controlled trials; behavioural intervention related to sexual behaviour; included adults diagnosed with SMI; and if a behavioural outcome was reported. The Cochrane Assessment of Bias Tool was used. Of the initial 515 papers identified, 11 trials were included for quality assessment and data extraction. The studies were heterogeneous in content and dose of intervention, as well as outcome measure and follow-up periods, and all had some risk of bias. Four of the studies demonstrated significant improvement in safer sexual behaviour at follow up, but this effect diminished over time. The effect sizes were extremely variable. There is emerging evidence to suggest that a behavioural intervention has the potential to reduce sexual risks in people diagnosed with SMI. However, further high-quality research is needed in this area.
被诊断患有严重精神疾病（SMI）的人感染艾滋病毒的风险高于普通人群。然而，对于如何最好地降低该群体的性风险行为，人们关注甚少。本综述的目的是评估行为干预对促进被诊断患有SMI的人性安全行为的有效性。我们对相关数据库进行了全面检索，纳入的研究需为随机对照试验；与性行为相关的行为干预；纳入被诊断患有SMI的成年人；且报告了行为结果。使用了Cochrane偏倚评估工具。在最初识别出的515篇论文中，有11项试验被纳入质量评估和数据提取。这些研究在干预内容和剂量、结果测量以及随访期方面存在异质性，并且都存在一定的偏倚风险。其中四项研究表明，随访时安全性行为有显著改善，但这种效果会随着时间减弱。效应大小差异极大。有新证据表明，行为干预有可能降低被诊断患有SMI者的性风险。然而，该领域还需要进一步的高质量研究。
