Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-05T04:20:44.561Z Has data issue: false hasContentIssue false

HIV infection in psychiatric patients: An unlinked anonymous study

Published online by Cambridge University Press:  31 January 2018

José L. Ayuso-Mateos*
Affiliation:
Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués Valdecilla”, University of Cantabria, Santander, Spain
Francisco Montañés
Affiliation:
Department of Psychiatry, University Hospital San Carlos, Madrid, Spain, MD
Ismael Lastra
Affiliation:
Psychiatric Hospital “Ntra Sra. del Rosario”, Clinical and Social Psychiatry Research Unit, Santander, Spain
Juan J. Picazo De La Garza
Affiliation:
Department of Microbiology, University Hospital SanCarlos, Madrid, Spain
José L. Ayuso-Gutiérrez
Affiliation:
Department of Psychiatry, University Hospital San Carlos, Madrid, Spain, MD
*
Prof. J. L. Ayuso-Mateos, Unidad de lnvestigación en Psiquiatria Clínica y Social, Hospital Universitario “Marqués de Valdecilla”, Avda. Valdecilla s/n, 39008 Santander, Spain

Abstract

Background

Recent surveys suggest that psychiatric patients are at increased risk of being infected with HIV, although very little information is available concerning the seroprevalence of HIV infection among this population outside the US. The aim of this study is to determine the seroprevalence of HIV-I among patients admitted to a psychiatric in-patient unit and to gather linked anonymous risk-factor information.

Method

An unlinked serosurvey was made, using HIV-1 antibody testing of remnant blood specimens collected for routine medical purposes, of patients consecutively admitted to an acute psychiatric unit in Madrid.

Results

Blood was obtained from 390 of the 477 eligible patients (81.8%). The prevalence of HIV was 5.1% (20/390). Patients aged between 18 and 39 accounted for 63.4% of the admissions and 75% of the positive results. Of the 29 patients who presented with injecting drug use, 14 were HIV-infected (48.3%; 95% CI 29.4 67.5). Of the 51 patients for whom any risk behaviour was noted on the admission chart, 18 were HIV-infected (35.3%; 95% CI 22.4 49.9).

Conclusions

This study demonstrates that there is a substantial prevalence of HIV infection in psychiatric patients admitted to an acute in-patient unit. History of injecting drug use was strongly associated with seropositivity. Clinicians recognised risk factors for HIV infection in the majority of the HIV-infected cases.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ayuso, J., Lastra, L. & Gonzalaz, J. C. (1991) Study of patients with HIV infection requiring psychiatric hospitalization. VIII International Conference on AIDS, 7023 (abstract).Google Scholar
Avins, A. L., Woods, W., Lindan, C., et al (1994) HIV infection and risk behaviours among heterosexuals in alcohol treatment programs. Journal of the American Medical Association, 271, 515518.CrossRefGoogle ScholarPubMed
Baer, J. W., Hall, J. M., Holm, K., et al (1987) Challenges in devloping an inpatient psychiatric program for patients with AIDS and ARC. Hospital and Community Psychiatry 38, 12991303.Google Scholar
Bayer, R. (1993) The ethics of blinded HIV surveillance testing, American Journal of Public Health, 83, 496497.CrossRefGoogle ScholarPubMed
Bayer, R., Lurney, L. & Wan, L. (1998) The American. British and Dutch responses to unlinked anonymous HIV seroprevalence studies: an international comparison. AIDS, 4, 283290.Google Scholar
Cournos, F., Emfield, M., Horward, E., et al (1990) HIV infection in state hospitals: case reports and long-term management strategies. Hospital and Community Psychiatry, 41, 163166.Google ScholarPubMed
Cournos, F., Emfield, M., Horward, E., et al (1991) HIV seroprevalence among patients admitted to two psychiatric hospitals. American Journal of Psychiatry, 148, 12251230.Google Scholar
Cournos, F., Emfield, M., Horward, E., McKinnon, K., Meyor-Bahlburg, H., et al (1991) HIV risk activity among persons with severe mental illness; preliminary findings. Hospital and Community Psychiatry 44, 11041106.Google Scholar
Cournos, F., Emfield, M., Horward, E., McKinnon, K., Meyor-Bahlburg, H., Gudio, J., Coomaraswamy, S., et al (1994) Sexual activity and risk of HIV infection among patients with schizophrenia. American Journal of Psychiatry, 151, 228232.Google Scholar
DiClemente, R., & Ponton, L. E. (1993) HIV-related risk behaviours anriong psychiatrically hospitalized adolescents and school-based adolescents. American Journal of Psychiatry 150, 324325.Google Scholar
Dondero, T. J., Pappaioanou, M. & Curran, J. W. (1988) Monitoring the levels and trends of HIV infection. The Public Health Services Report. 103, 213220.Google Scholar
Empfield, M., Cournos, P., Mayor, I., et al (1993) HIV seroprevalence among patients admitted to a psychiatric inpatient unit. American Journal of Psychiatry, 150, 4752.Google Scholar
Kalichman, S. C., Kelly, J. A., Johnson, J. R., et al (1994) Factors associated with risk for HIV infection among chronic mentally ill adults. American Journal of Psychiatry, 151, 221227.Google Scholar
Kalichman, S. C., Kelly, J. A., Johnson, J. R., Sikkoma, K. J., Kelly, J. A., et al (1995) Use of a brief behavioural skills intervention to prevent HIV infection anriong chronic mentally ill adults. Psychiatric Services, 46, 275280.Google Scholar
Kelly, J. A., Dobra, A. M., Bahr, G. R., et al (1994) AIDS/HIV risk behaviour among the chronic mentally ill. American Journal of Psychiatry, 149, 886890.Google Scholar
Kirp, , & D. L. & Bayer, R. (1992) AIDS in the Industrialized Democracies: Passions, Politics and Policies, New Brunswick, NJ, Rutgers University Press.Google Scholar
Mahlar, J., Yi, D., Sacks, M., et al (1994) Undetected HIV infection among patients admitted to an alcohol rehabilitation unit. American Journal of Psychiatry, 151, 439440.Google Scholar
McDormont, B., Sautter, F. J., Winstead, D. K., et al (1994) Diagnosis, health beliefs, and risk of HIV infection in psychiatric patients. Hospital and Community Psychiatry 45, 580585.Google Scholar
Menon, A. S., Pomerantz, S., Harowitz, S., et al, (1994) The high prevalence of unsafe sexual behaviours among acute psychiatric patients. Journal of Nervous and Mental Diseases. 182, 661666.Google Scholar
Meyer, I., McKinnon, K., Cournos, F., et al (1993) HIV seroprevalence among long-stay psychiatric inpatients. Hospital and Community Psychiatry 44, 281284.Google Scholar
Naber, D., Pajonk, F. G., Perro, C., et al (1994) Human immunodeficiency virus antibody test and seroprevalence in psychiatric patients. Acta Psychiatrica Scandinavica, 89, 358361.CrossRefGoogle ScholarPubMed
Ostrow, D. G. (1992) HIV counselling and testing of psychiatric patients, time to reexamine policy and practices. General Hospital Psychiatry, 14, 12.Google Scholar
Plan Nacional Sobre el Sida (1994) Epidemiologia del SIDA en Espańa, Situación en el Contexto Mundial, Madrid: Ministerio de Sanidad y Consumo.Google Scholar
Regier, D. A., Farmer, M. E., Rae, D. S., et al (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiological Catchment Area (ECA) Study. Journal of the American Medical Association. 264, 25112518.CrossRefGoogle ScholarPubMed
Sacks, M., Dermatis, H., Looser-Ott, S., et al (1992) Undetected HIV infection among acutely ill psychiatric inpatients. American Journal of Psychiatry, 149, 544545.Google Scholar
Silberstein, M. V., Galanter, M., Marmor, M., et al (1994) HIV-I among inner city dually diagnosed inpatients. American Journal of Drug and Alcohol Abuse, 201, 201213.Google Scholar
Stefen, M. & Catalán, J. (1995) Psychiatric patients and HIV infection: a new population at risk. British Journal of Psychiatry, 167, 721727.Google Scholar
Strain, J. & Forstein, M. (1991) Yes and no. Viewpoints-Crossfire: Its time to require HIV mandatory testing of all hospitalized inpatients. Psychiatric News, 15, 930.Google Scholar
Susser, E., Valancia, E. & Conover, S. (1993) Prevalence of infection among psychiatric patients in a New York City men's shelter. American Journal of Public Health, 83, 568570.Google Scholar
Susser, E., & Conover, S., Valancia, E., Miller, M., et al (1995) Sexual behaviour of homeless mentally ill men at risk for HIV. American Journal of Psychiatry, 152, 583587.Google Scholar
World Health Organization (1989) Unlinked Anonymous Screening for the Public Health Surveillance of HIV Infections: Proposed International Guidelines. Geneva: WHO Global Programme on AIDS.Google Scholar
Zemeperetti, M., Goldwurn, G. F., Abbeta, E. et al (1990) Attempted suicide and HIV infection: epidemiological aspects in a psychiatric ward. In Abstracts, VI International Conference on Aids, p 182. Los Angeles, American Foundation for AIDS Research.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.