Tynes L L, Sautter F J, McDermott B E, Winstead D K
Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, La. 70112.
South Med J. 1993 Mar;86(3):276-81. doi: 10.1097/00007611-199303000-00003.
Recent data suggest that the homeless and those with chronic mental illness may be at increased risk for HIV infection. A review of the recent literature reveals insufficient rigorously collected data to identify with confidence any particular subgroup of chronically mentally ill patients at increased risk. Nonetheless, it seems reasonable to suspect that those with acute psychosis, a history of substance abuse, or a history of sexual abuse may be at higher risk. Conversely, some data currently support the conclusion that homeless persons are at increased risk for infection due to human immunodeficiency virus (HIV). Clinicians of all disciplines should be aware of these findings and be particularly vigilant when patients are members of both aforementioned groups. Future research should focus upon improving service delivery to the homeless and mentally ill, particularly with regard to sex education and substance abuse intervention. Also, continued research into causal influences of homelessness will ultimately lead to more definitive intervention.
近期数据表明，无家可归者和患有慢性精神疾病的人感染艾滋病毒的风险可能更高。对近期文献的回顾显示，缺乏经过严格收集的数据，无法确切确定任何特定的慢性精神病患者亚组感染风险增加。尽管如此，怀疑患有急性精神病、有药物滥用史或性虐待史的人可能风险更高似乎是合理的。相反，目前一些数据支持这样的结论，即无家可归者感染人类免疫缺陷病毒（HIV）的风险增加。所有学科的临床医生都应了解这些发现，当患者属于上述两个群体时要格外警惕。未来的研究应侧重于改善为无家可归者和精神疾病患者提供的服务，特别是在性教育和药物滥用干预方面。此外，对无家可归的因果影响持续进行研究最终将带来更明确的干预措施。
