精神分裂症患者的性传播感染、性生活及风险行为：系统评价与荟萃分析

Sexually transmitted infections, sexual life and risk behaviours of people living with schizophrenia: systematic review and meta-analysis.

作者信息

Aymerich Claudia, Pedruzo Borja, Salazar de Pablo Gonzalo, Madaria Lander, Goena Javier, Sanchez-Gistau Vanessa, Fusar-Poli Paolo, McGuire Philip, González-Torres Miguel Ángel, Catalan Ana

机构信息

Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain; Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain; and Neuroscience Department, University of the Basque Country, Leioa, Spain.

Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain.

出版信息

BJPsych Open. 2024 May 10;10(3):e110. doi: 10.1192/bjo.2024.49.

DOI:10.1192/bjo.2024.49

PMID:38725352

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11094452/

Abstract

BACKGROUND

Sexually transmitted infections (STIs), along with sexual health and behaviour, have received little attention in schizophrenia patients.

AIMS

To systematically review and meta-analytically characterise the prevalence of STIs and sexual risk behaviours among schizophrenia patients.

METHOD

Web of Science, PubMed, BIOSIS, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, SciELO and Cochrane Central Register were systematically searched from inception to 6 July 2023. Studies reporting on the prevalence or odds ratio of any STI or any outcome related to sexual risk behaviours among schizophrenia samples were included. PRISMA/MOOSE-compliant (CRD42023443602) random-effects meta-analyses were used for the selected outcomes. Q-statistics, index, sensitivity analyses and meta-regressions were used. Study quality and publication bias were assessed.

RESULTS

Forty-eight studies ( = 2 459 456) reporting on STI prevalence (including 15 allowing for calculation of an odds ratio) and 33 studies ( = 4255) reporting on sexual risk behaviours were included. Schizophrenia samples showed a high prevalence of STIs and higher risks of HIV (odds ratio = 2.11; 95% CI 1.23-3.63), hepatitis C virus (HCV, odds ratio = 4.54; 95% CI 2.15-961) and hepatitis B virus (HBV; odds ratio = 2.42; 95% CI 1.95-3.01) infections than healthy controls. HIV prevalence was higher in Africa compared with other continents and in in-patient (rather than out-patient) settings. Finally, 37.7% (95% CI 31.5-44.4%) of patients were sexually active; 35.0% (95% CI 6.6-59.3%) reported consistent condom use, and 55.3% (95% CI 25.0-82.4%) maintained unprotected sexual relationships.

CONCLUSIONS

Schizophrenia patients have high prevalence of STIs, with several-fold increased risks of HIV, HBV and HCV infection compared with the general population. Sexual health must be considered as an integral component of care.

摘要

背景

性传播感染（STIs）以及性健康和性行为在精神分裂症患者中很少受到关注。

目的

系统评价并通过荟萃分析描述精神分裂症患者中性传播感染的患病率和性风险行为。

方法

对Web of Science、PubMed、BIOSIS、KCI - 韩国期刊数据库、MEDLINE、俄罗斯科学引文索引、SciELO和Cochrane中央注册库进行系统检索，检索时间从建库至2023年7月6日。纳入报告精神分裂症样本中性传播感染的患病率或比值比以及与性风险行为相关的任何结果的研究。对选定的结果采用符合PRISMA/MOOSE标准（CRD42023443602）的随机效应荟萃分析。使用Q统计量、I²指数、敏感性分析和荟萃回归分析。评估研究质量和发表偏倚。

结果

纳入48项报告性传播感染患病率的研究（n = 2459456）（其中15项可计算比值比）以及33项报告性风险行为的研究（n = 4255）。精神分裂症样本显示性传播感染的患病率较高，与健康对照组相比，感染人类免疫缺陷病毒（HIV）的风险更高（比值比 = 2.11；95%置信区间1.23 - 3.63）、丙型肝炎病毒（HCV，比值比 = 4.54；95%置信区间2.15 - 9.61）和乙型肝炎病毒（HBV；比值比 = 2.42；95%置信区间1.95 - 3.01）。与其他大洲相比，非洲的HIV患病率更高，且在住院（而非门诊）环境中更高。最后，37.7%（95%置信区间31.5 - 44.4%）的患者有性活动；35.0%（95%置信区间6.6 - 59.3%）报告始终使用避孕套，55.3%（95%置信区间25.0 - 82.4%）保持无保护的性关系。