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针对严重精神疾病患者的艾滋病预防建议。

HIV prevention advice for people with serious mental illness.

作者信息

Wright Nicola, Akhtar Athfah, Tosh Graeme E, Clifton Andrew V

机构信息

School of Health Sciences, University of Nottingham, Institute of Mental Health, Triumph Road, Nottingham, UK, NG7 2TU.

出版信息

Cochrane Database Syst Rev. 2016 Sep 9;9(9):CD009639. doi: 10.1002/14651858.CD009639.pub3.

Abstract

BACKGROUND

People with serious mental illness have rates of Human Immuno-deficiency Virus (HIV) infection higher than expected in the general population for the same demographic area. Despite this elevated prevalence, UK national strategies around sexual health and HIV prevention do not state that people with serious mental illness are a high risk group. However, a significant proportion in this group are sexually active and engage in HIV-risk behaviours including having multiple sexual partners, infrequent use of condoms and trading sex for money or drugs. Therefore we propose the provision of HIV prevention advice could enhance the physical and social well being of this population.

OBJECTIVES

To assess the effects of HIV prevention advice in reducing morbidity, mortality and preserving the quality of life in people with serious mental illness.

SEARCH METHODS

We searched the Cochrane Schizophrenia Group's Trials Register (24 January 2012; 4 July 2016).

SELECTION CRITERIA

We planned to include all randomised controlled trials focusing on HIV prevention advice versus standard care or comparing HIV prevention advice with other more focused methods of delivering care or information for people with serious mental illness.

DATA COLLECTION AND ANALYSIS

Review authors (NW, AC, AA, GT) independently screened search results and did not identify any studies that fulfilled the review's criteria.

MAIN RESULTS

We did not identify any randomised studies that evaluated advice regarding HIV for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to both people with serious mental illness and HIV risk are possible.

AUTHORS' CONCLUSIONS: Policy makers, clinicians, researchers and service users need to collaborate to produce guidance on how best to provide advice for people with serious mental illness in preventing the spread of HIV infection. It is entirely feasible that this could be within the context of a well-designed simple large randomised study.

摘要

背景

在相同人口统计学区域内,患有严重精神疾病的人群感染人类免疫缺陷病毒(HIV)的比例高于普通人群的预期。尽管患病率有所上升,但英国围绕性健康和HIV预防的国家战略并未表明患有严重精神疾病的人群是高危群体。然而,该群体中有很大一部分人有性活动,并从事包括拥有多个性伴侣、不经常使用避孕套以及以性换钱或毒品等HIV风险行为。因此,我们建议提供HIV预防建议可以改善这一人群的身心健康。

目的

评估HIV预防建议对降低患有严重精神疾病人群的发病率、死亡率以及维持生活质量的效果。

检索方法

我们检索了Cochrane精神分裂症研究组试验注册库(2012年1月24日;2016年7月4日)。

选择标准

我们计划纳入所有聚焦于HIV预防建议与标准护理对比,或比较HIV预防建议与其他更有针对性的为患有严重精神疾病人群提供护理或信息方法的随机对照试验。

数据收集与分析

综述作者(NW、AC、AA、GT)独立筛选检索结果,未识别出任何符合综述标准的研究。

主要结果

我们未识别出任何评估针对患有严重精神疾病人群的HIV相关建议的随机研究。被排除的研究表明,对与患有严重精神疾病和HIV风险相关的一揽子护理进行随机分组是可行的。

作者结论

政策制定者、临床医生、研究人员和服务使用者需要合作,就如何最好地为患有严重精神疾病人群提供预防HIV感染传播的建议制定指南。在精心设计的简单大型随机研究背景下做到这一点完全可行。

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本文引用的文献

1
Smoking cessation advice for people with serious mental illness.针对患有严重精神疾病者的戒烟建议。
Cochrane Database Syst Rev. 2016 Jan 28;1(1):CD009704. doi: 10.1002/14651858.CD009704.pub2.
2
Oral health advice for people with serious mental illness.针对严重精神疾病患者的口腔健康建议。
Cochrane Database Syst Rev. 2011 Nov 9(11):CD008802. doi: 10.1002/14651858.CD008802.pub2.
3
General physical health advice for people with serious mental illness.针对严重精神疾病患者的一般身体健康建议。
Cochrane Database Syst Rev. 2011 Feb 16(2):CD008567. doi: 10.1002/14651858.CD008567.pub2.
4
Physical health care monitoring for people with serious mental illness.严重精神疾病患者的身体健康监测
Cochrane Database Syst Rev. 2010 Mar 17(3):CD008298. doi: 10.1002/14651858.CD008298.pub2.
7
Serious mental illness and physical health problems: a discussion paper.严重精神疾病与身体健康问题:一篇讨论文件。
Int J Nurs Stud. 2007 Mar;44(3):457-66. doi: 10.1016/j.ijnurstu.2006.07.013. Epub 2006 Sep 27.
8
A randomized trial of a brief HIV risk reduction intervention for men with severe mental illness.
Psychiatr Serv. 2006 Mar;57(3):407-9. doi: 10.1176/appi.ps.57.3.407.

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