Kalichman S C, Kelly J A, Johnson J R, Bulto M
Department of Psychiatry and Mental Health Sciences, Medical College of Wisconsin, Milwaukee 53226.
Am J Psychiatry. 1994 Feb;151(2):221-7. doi: 10.1176/ajp.151.2.221.
Chronic mentally ill adults have been found to be at risk for HIV infection. The authors investigated the prevalence of HIV risk behaviors among psychiatric outpatients. Correlates of HIV risk factors and characteristics of patient relationships in which risk occurred were investigated.
Structured interviews were conducted with 95 chronic mentally ill adults from urban community support service programs. The interviews focused on sexual and substance use behavior, history of HIV risk behaviors, and relationship characteristics related to risk.
The study showed that 27% of all patients had had two or more sex partners in the previous year and 18% had received money or drugs for sex. High rates of illicit drug use were also found, with frequent use of drugs or alcohol in association with sexual activity. Multiple regression analyses showed that use of illicit drugs, meeting sex partners in psychiatric clinics, and meeting partners in bars accounted for a substantial proportion of the variance in HIV risk behavior.
These results suggest an urgent need for HIV prevention programs targeted at urban chronic mentally ill adults. Risk-producing characteristics of patient relationships and social networks should be addressed in the development of prevention interventions.
已发现成年慢性精神病患者存在感染艾滋病毒的风险。作者调查了精神科门诊患者中艾滋病毒风险行为的流行情况。研究了艾滋病毒风险因素的相关因素以及发生风险的患者关系特征。
对来自城市社区支持服务项目的95名成年慢性精神病患者进行了结构化访谈。访谈重点关注性行为和物质使用行为、艾滋病毒风险行为史以及与风险相关的关系特征。
研究表明,所有患者中有27%在过去一年中有两个或更多性伴侣,18%曾因性行为获得金钱或毒品。还发现非法药物使用率很高,经常在性行为时使用毒品或酒精。多元回归分析表明,使用非法药物、在精神科诊所结识性伴侣以及在酒吧结识伴侣在艾滋病毒风险行为的差异中占很大比例。
这些结果表明迫切需要针对城市成年慢性精神病患者开展艾滋病毒预防项目。在制定预防干预措施时应考虑患者关系和社会网络中产生风险的特征。