HIV prevention advice for people with serious mental illness.

Cochrane Database Syst Rev

School of Health Sciences, University of Nottingham, Institute of Mental Health, Triumph Road, Nottingham, NG7 2TU, UK.

Published: December 2014

AI Article Synopsis

  • People with serious mental illness have a higher incidence of HIV compared to the general population, yet UK HIV prevention strategies do not recognize them as a high-risk group despite their risky sexual behaviors.
  • Research aimed to determine if HIV prevention advice could improve health outcomes and quality of life for this population.
  • A review of existing studies found no randomized controlled trials assessing the impact of HIV prevention advice for individuals with serious mental illness.

Article Abstract

Background: People with serious mental illness have rates of Human Immuno-deficiency Virus (HIV) infection higher than expected in the general population for the same demographic area. Despite this elevated prevalence, UK national strategies around sexual health and HIV prevention do not state that people with serious mental illness are a high risk group. However, a significant proportion in this group are sexually active and engage in HIV-risk behaviours including having multiple sexual partners, infrequent use of condoms and trading sex for money or drugs. Therefore we propose the provision of HIV prevention advice could enhance the physical and social well being of this population.

Objectives: To assess the effects of HIV prevention advice in reducing morbidity, mortality and preserving the quality of life in people with serious mental illness.

Search Methods: We searched the Cochrane Schizophrenia Group's Trials Register (24 January, 2012), which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register.

Selection Criteria: We planned to include all randomised controlled trials focusing on HIV prevention advice versus standard care or comparing HIV prevention advice with other more focused methods of delivering care or information for people with serious mental illness.

Data Collection And Analysis: Review authors (NW, AC, AA, GT) independently screened search results and did not identify any studies that fulfilled the review's criteria.

Main Results: We did not identify any randomised studies that evaluated advice regarding HIV for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to both people with serious mental illness and HIV risk are possible.

Authors' Conclusions: Policy makers, clinicians, researchers and service users need to collaborate to produce guidance on how best to provide advice for people with serious mental illness in preventing the spread of HIV infection. It is entirely feasible that this could be within the context of a well-designed simple large randomised study.

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Source
http://dx.doi.org/10.1002/14651858.CD009639.pub2DOI Listing

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