Lundberg Patric, Nakasujja Noeline, Musisi Seggane, Thorson Anna Ekéus, Cantor-Graae Elizabeth, Allebeck Peter
Patric Lundberg, Peter Allebeck, and Anna Ekéus Thorson are with the Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. Noeline Nakasujja and Seggane Musisi are with the Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda. Elizabeth Cantor-Graae is with the Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Am J Public Health. 2015 Jun;105(6):1142-8. doi: 10.2105/AJPH.2014.302479. Epub 2015 Apr 16.
We investigated prevalence of past-year sexual risk behavior and sexual violence exposure in persons with severe mental illness (SMI) in Uganda, and compared results to general population estimates. We also investigated whether persons with SMI reporting sexual risk behavior and sexual violence exposure were more likely to be HIV-infected.
We included 602 persons consecutively discharged from Butabika Hospital, Kampala, Uganda, February to April 2010. We asked about past-year number of sexual partners and condom use. We assessed sexual violence with the World Health Organization Violence Against Women Instrument. We performed HIV testing. We used data from 2011 Uganda Demographic and Health Survey for comparison.
Women with SMI had more sexual risk behavior and more sexual violence exposure than women in the general population. We found no difference in sexual risk behavior in men. Sexual risk behavior was associated with HIV infection in men, but not women. Sexual violence exposure was not associated with HIV infection in women.
Findings suggest that SMI exacerbates Ugandan women's sexual vulnerability. Public health practitioners, policymakers, and legislators should act to protect health and rights of women with SMI in resource-poor settings.
我们调查了乌干达严重精神疾病（SMI）患者过去一年的性风险行为和性暴力暴露情况，并将结果与一般人群的估计数据进行比较。我们还调查了报告有性风险行为和性暴力暴露的SMI患者感染艾滋病毒的可能性是否更高。
我们纳入了2010年2月至4月期间从乌干达坎帕拉布塔比卡医院连续出院的602人。我们询问了过去一年的性伴侣数量和避孕套使用情况。我们使用世界卫生组织的暴力侵害妇女工具评估性暴力。我们进行了艾滋病毒检测。我们使用2011年乌干达人口与健康调查的数据进行比较。
与一般人群中的女性相比，患有SMI的女性有更多的性风险行为和更多的性暴力暴露。我们发现男性的性风险行为没有差异。性风险行为与男性的艾滋病毒感染有关，但与女性无关。性暴力暴露与女性的艾滋病毒感染无关。
研究结果表明，严重精神疾病加剧了乌干达女性的性脆弱性。公共卫生从业者、政策制定者和立法者应采取行动，在资源匮乏的环境中保护患有严重精神疾病的妇女的健康和权利。
