Human immunodeficiency virus-related risk behavior among Italian psychiatric inpatients

Individual and treatment setting predictors of HIV/AIDS knowledge among psychiatric patients and their implications in a national multisite study in Brazil

The objective of this study is to measure HIV/AIDS knowledge among patients with mental illness in Brazil and to examine individual and treatment setting predictors of knowledge. We conducted a cross-sectional national multicenter study among 2,475 patients in 26 randomly selected mental health institutions throughout Brazil. We used Item Response Theory to standardize knowledge scores and multilevel multiple linear regression to determine the effect of individual and treatment setting characteristics on standardized knowledge score. Schizophrenia was the main diagnosis (48%) of participants. Mean knowledge score was 6.78 (range 1-10). Treatment setting characteristics were not associated with knowledge scores. Higher HIV/AIDS knowledge scores were significantly associated with a history of sexually transmitted disease (STD), previous HIV testing and consistent condom use; lower HIV/AIDS knowledge scores were significantly associated with specific sociodemographic, psychiatric, and HIV risk-perception factors. Psychiatric patients in Brazil lag behind the general population with knowledge scores comparable to those of nearly a decade ago. The mental health system in Brazil and elsewhere must consider strategies beyond dispensing information, for preventing HIV/AIDS transmission in the psychiatric population.

Knowledge and attitude regarding human immunodeficiency virus/acquired immunodeficiency syndrome in dermatological outpatients

BACKGROUND

Dermatologists are often the first-line specialists who recognize and diagnose human immunodeficiency virus (HIV) infection because of pathognomic skin signs. It is therefore important to investigate attitudes and knowledge regarding HIV/acquired immunodeficiency syndrome (AIDS) amongst dermatological patients in order to provide information for dermatologists and to draw their attention to the issues.

OBJECTIVES

Awareness of HIV/AIDS, its prevention, and hypothetical behaviour were surveyed in dermatological outpatients.

PATIENTS/METHOD

The anonymous cross-sectional survey was conducted with consecutive German-speaking outpatients aged 18-65 years, who registered at the dermatological outpatient's clinic (excluding venereology, genitourinary or HIV medicine) of the University of Munich (Germany).

RESULTS

Three hundred forty-seven (77.5%) questionnaires were accepted for analysis. Most of the patients knew about HIV incurability (89.4%), HIV transmissibility during needle sharing (95.3%), or vaginal (87.4%) and anal intercourse (79.5%), as well as about HIV prevention by condom use (97.8%), and use of single needles (76.2%). However, knowledge gaps and misconceptions were detected regarding the risk of HIV transmission during oral sex, and the efficacy of sexual fidelity and avoidance of blood transfusions in HIV prevention. The lowest knowledge level (< 50% correct answers) was detected in patients aged 50-59 years, in unemployed, divorced/widowed, and in those without or with incomplete school education.

CONCLUSIONS

Patient education about HIV/AIDS in dermatological ambulant settings should be performed differentially with regard to socio-demographic factors, and focused on the topic of oral sexual HIV transmission and on some other specific misconceptions.

'Veiling sexualities': a grounded theory of mental health nurses responses to issues of sexuality

AIM

This paper is a report of a study to develop a grounded theory explaining how mental health nurses respond to issues of sexuality in clinical practice.

BACKGROUND

The history of sexuality and people with mental health problems has largely been a history shrouded in misunderstanding, stigma, myth and negativity. However, individuals with mental health problems may experience sexuality and relationship difficulties related to their life experiences, mental illness, or its treatment.

METHODS

Grounded theory was the methodology used for the study. Interviews were conducted in 2005-2006 with 27 mental health nurses working an urban area in the Republic of Ireland. Data were analysed using the concurrent processes of constant comparative analysis, data collection, theoretical sampling and memo writing.

FINDINGS

The core category to emerge from the data was 'veiling sexualities'. This refers to participants' accounts of how they responded to the sexuality dimension of clients' lives. Participants' main concerns about sexuality were related to feelings of personal and professional vulnerability, due to a lack of competence, comfort and confidence in this area. The theory highlights the manner in which nurses perpetuate practices that marginalize, discriminate and socially exclude clients as 'sexual citizens'.

CONCLUSION

The theory of Veiled Sexualities may facilitate acknowledgement of the presence of sexuality in all nurse-client encounters, and promote a discourse on the sexual rights of people experiencing mental distress among mental health nurses and all involved in the delivery of mental health services.

HIV, syphilis, and hepatitis B and C prevalence among patients with mental illness: a review of the literature

A limited number of studies worldwide have investigated the prevalence of HIV, syphilis, and hepatitis B and C infection among psychiatric patients. However, prevalence of these infections in the population with chronic mental illness has not been clearly established. Most of the published papers are from developed countries and have derived from relatively small and non-representative samples. We performed a systematic review of the published literature to identify studies on these infectious diseases within psychiatric populations in Brazil and other developing countries. Overall, prevalence rates varied from 0% to 29% for HIV; 1.6% to 66% for HBV; 0.4% to 38% for HCV; and 1.1% to 7.6% for syphilis. Several risk factors were identified and discussed, although sampling limitations restrict the generalization of study findings. This review highlights the lack of information on the prevalence of sexually transmitted diseases and their associated factors among persons with chronic mental illness and identifies gaps in the knowledge base in both developing and developed countries.

Neuroleptic medication and sexuality: the forgotten aspect of education and care

Discussing issues of sexuality is a challenging and difficult issue for many health care workers. When it comes to sexuality and people with mental health problems there seems to be a dual taboo. Mental health nurses are ideal members of the health care team to talk to service users about issues as sensitive as sexuality and the side effects of medication that impact on sexual health. However, in both clinical practice and the nursing literature, the side effects of medications that impact on sexual function are often ignored and unspoken about. This paper examines the impact of both conventional and atypical neuroleptic medication on sexual function and discusses the probable causes of such effects. The possible reasons why health care professionals are reluctant to discuss side effects impacting on sexual health with service users are explored and emphasis is placed on the need for mental health nurses to respond to requests from service users for more education and discussion in the area of sexuality and sexual health.