Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
South London and Maudsley NHS Foundation Trust, London, UK.
BMJ Open. 2023 Apr 25;13(4):e067337. doi: 10.1136/bmjopen-2022-067337.
To examine the prevalence of HIV in a cohort of people who have used secondary mental health services in the UK.
Retrospective cohort study.
Routinely collected clinical data from secondary mental health services in South London, UK available for research through the Clinical Record Interactive Search tool at the National Institute for Health and Care Research Maudsley Biomedical Research Centre were matched with pseudonymised national HIV surveillance data held by the UK Health Security Agency using a deterministic matching algorithm.
All adults aged 16+ who presented for the first time to mental health services in the South London and Maudsley (SLaM) National Health Service Trust between 1 January 2007 and 31 December 2018 were included.
Point prevalence of HIV.
There were 181 177 people who had contact with mental health services for the first time between 2007 and 2018 in SLaM. Overall, 2.47% (n=4481) of those had a recorded HIV diagnosis in national HIV surveillance data at any time (before, during or after contact with mental health services), 24.73 people per 1000. HIV point prevalence was highest in people with a diagnosed substance use disorder at 3.77% (n=784). A substantial percentage of the sample did not have a formal mental health diagnosis (27%), but even with those excluded, the point prevalence remained high at 2.31%. Around two-thirds of people had their diagnosis of HIV before contact with mental health services (67%; n=1495).
The prevalence of HIV in people who have had contact with mental health services was approximately 2.5 times higher than the general population in the same geographical area. Future work should investigate risk factors and disparities in HIV outcomes between those with and without mental health service contact.
调查在英国使用二级精神卫生服务的人群中艾滋病毒的流行率。
回顾性队列研究。
英国伦敦南部二级精神卫生服务机构的常规收集临床数据，可通过国家卫生与保健卓越研究所莫兹利生物医学研究中心的临床记录交互式搜索工具获取研究用，与英国卫生安全局持有的全国艾滋病毒监测匿名数据通过确定性匹配算法进行匹配。
所有在 2007 年 1 月 1 日至 2018 年 12 月 31 日期间首次在伦敦南部和莫兹利 (SLaM) 国民保健服务信托的精神卫生服务机构就诊的 16 岁及以上成年人均纳入研究。
艾滋病毒现患率。
在 2007 年至 2018 年期间，SLaM 有 181177 人首次接触精神卫生服务。总体而言，在全国艾滋病毒监测数据中，任何时候（在接触精神卫生服务之前、期间或之后）有记录的艾滋病毒诊断的人数占比为 2.47%（n=4481），即每 1000 人中 24.73 人。在诊断为物质使用障碍的人群中，艾滋病毒现患率最高，为 3.77%（n=784）。样本中有相当一部分人没有正式的精神卫生诊断（27%），但即使排除这些人，现患率仍高达 2.31%。约三分之二的人在接触精神卫生服务之前就已诊断出艾滋病毒（67%；n=1495）。
与同一地理区域的一般人群相比，接触过精神卫生服务的人群中艾滋病毒的流行率大约高 2.5 倍。未来的研究应调查有和无精神卫生服务接触者之间艾滋病毒结局的风险因素和差异。
