Mokgatle Mathildah Mpata
Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa.
School of Transdisciplinary Research and Graduate Studies, College of Graduate Studies, University of South Africa (UNISA), Muckleneuk, Pretoria 0001, South Africa.
Healthcare (Basel). 2021 Oct 19;9(10):1398. doi: 10.3390/healthcare9101398.
The rate of HIV and sexually transmitted infections among mental patients is higher than that of the general population worldwide. Many risky sexual behaviors are associated with mental illness. However, mental health care users (MHCUs) are not specifically targeted for HIV preventative care, and routine HIV testing is not done among this population. Limited studies have investigated self-reported HIV and STI prevalence and associated risky sexual behavior in persons with mental illnesses accessing health care services in South Africa in particular. This study set out to determine both the Sexually Transmitted Infections (STI) and human immunodeficiency virus (HIV) self-reported prevalence and sexual practices of MHCUs. A descriptive cross-sectional survey using purposive sampling was used to select 107 MHCUs across five clinics within Gauteng Province of South Africa who were above the age of 18, had a mental illness, and were currently stable and receiving chronic medication. Descriptive statistics were performed using Stata IC version 16. The chi square test was used to indicate statistical significance ( < 0.05) of differences in frequency distributions. More males (52.5%) than females were currently in a sexual relationship (50.0%), having multiple sexual partners ( = 4.13%), and having alcohol-driven sex ( = 4.19%). The majority of MHCUs ( = 82.77%) had an STI in the past six months, and a quarter ( = 21.25%) were HIV-positive with over two-thirds of MHCU ( = 69.70%) perceiving themselves not at risk for HIV. MHCUs engaged in risky behaviors had a low perception of the risks of contracting HIV. Bivariate analysis of gender by sexual behavior revealed that female MHCUs are more at risk of being forced to have sex compared to males ( = 0.006). Integrated interventions should be put in place to ensure that MHCUs' sexual and reproductive health are not left behind and issues such as sexual education, safe sex, and sexually transmitted infections should form part of the care of MHCUs.
在全球范围内，精神疾病患者中艾滋病毒和性传播感染的发生率高于普通人群。许多危险的性行为都与精神疾病有关。然而，精神卫生保健使用者并未被专门纳入艾滋病毒预防保健的对象范围，且该人群中也未进行常规艾滋病毒检测。尤其是在南非，针对使用卫生保健服务的精神疾病患者中自我报告的艾滋病毒和性传播感染患病率以及相关危险行为的研究有限。本研究旨在确定精神卫生保健使用者的性传播感染（STI）和人类免疫缺陷病毒（HIV）自我报告患病率及性行为情况。采用立意抽样的描述性横断面调查，从南非豪登省的五家诊所中选取了107名年龄在18岁以上、患有精神疾病、目前病情稳定且正在接受长期药物治疗的精神卫生保健使用者。使用Stata IC 16版本进行描述性统计分析。卡方检验用于表明频率分布差异的统计学显著性（<0.05）。目前处于性关系中的男性（52.5%）多于女性（50.0%），有多个性伴侣的男性（=4.13%）和有酒精促发性行为的男性（=4.19%）更多。大多数精神卫生保健使用者（=82.77%）在过去六个月内患有性传播感染，四分之一（=21.25%）为艾滋病毒阳性，超过三分之二的精神卫生保健使用者（=69.70%）认为自己没有感染艾滋病毒的风险。有危险行为的精神卫生保健使用者对感染艾滋病毒的风险认知较低。性行为的性别双变量分析显示，与男性相比，女性精神卫生保健使用者被迫发生性行为的风险更高（=0.006）。应实施综合干预措施，以确保精神卫生保健使用者的性健康和生殖健康不落伍，性教育、安全性行为和性传播感染等问题应成为精神卫生保健使用者护理工作的一部分。
