Hobkirk Andréa L, Towe Sheri L, Lion Ryan, Meade Christina S
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 90519, Durham, NC, 27708, USA.
Duke Global Health Institute, Duke University, 310 Trent Drive, Trent Hall, Durham, NC, 27708, USA.
Curr HIV/AIDS Rep. 2015 Dec;12(4):406-12. doi: 10.1007/s11904-015-0294-4.
Persons with severe mental illness (SMI) have been disproportionately affected by the HIV epidemic, with higher rates of HIV prevalence and morbidity than the general population. Recent research has advanced our understanding of the complex factors that influence primary and secondary HIV prevention for those with SMI. Sex risk in this population is associated with socioeconomic factors (e.g., low income, history of verbal violence) and other health risk behaviors (e.g., substance use, no prior HIV testing). Several interventions are effective at reducing risk behavior, and reviews highlight the need for more well-controlled studies that assess long-term outcomes. Recent research has elucidated barriers that interfere with HIV treatment for SMI populations, including individual (e.g., apathy, substance use), social (e.g., stigma), and system factors (e.g., transportation, clinic wait times). Interventions that coordinate HIV care for individuals with SMI show promise as cost-effective methods for improving medication adherence and quality of life.
严重精神疾病患者受艾滋病毒疫情的影响尤为严重,其艾滋病毒流行率和发病率高于普通人群。最近的研究增进了我们对影响严重精神疾病患者艾滋病毒一级和二级预防的复杂因素的理解。该人群中的性风险与社会经济因素(如低收入、言语暴力史)和其他健康风险行为(如药物使用、未进行过艾滋病毒检测)有关。几种干预措施在降低风险行为方面有效,综述强调需要更多评估长期结果的严格对照研究。最近的研究阐明了妨碍严重精神疾病患者接受艾滋病毒治疗的障碍,包括个人因素(如冷漠、药物使用)、社会因素(如耻辱感)和系统因素(如交通、诊所候诊时间)。为严重精神疾病患者协调艾滋病毒护理的干预措施有望成为提高药物依从性和生活质量的具有成本效益的方法。