HIV prevention advice for people with serious mental illness

Wright, Nicola; Akhtar, Athfah; Tosh, Graeme; Clifton, Andrew

doi:10.1002/14651858.cd009639.pub2

Cited by 7 publications

(6 citation statements)

References 45 publications

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“…Notably, few new intervention studies for people with SMI have been published since 2012, and studies from Africa, Asia, or Latin America are scarce [2]. The absence in the literature is mirrored by diminishing attention to HIV prevention, access to HIV services in public mental health settings in the United States [95].…”

Section: What Do We Know About Interventions That Address Mental Health In the Context Of Hiv Prevention?mentioning

confidence: 99%

“…In sub-Saharan Africa, adolescent girls and young women (aged 15 to 24 years) account for 24% of new HIV infections despite representing only 10% of the population [1]. People with severe mental illnesses (SMI) are also over-represented among new HIV infections [2,3]. A diverse range of HIV prevention practices and technologies are effective, acceptable and increasingly available in many settings, including condom distribution and voluntary testing and counselling [4], universal test-andtreat [5], voluntary medical male circumcision (VMMC) [6], oral pre-exposure prophylaxis (PrEP) [7], the dapivirine ring and other new, longer-acting PrEP modalities [8] and combination prevention packages incorporating behavioural, biological and structural interventions [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…From 2014 to 2016, several reviews reported the evidence on the need for and results of HIV prevention interventions focusing on people with SMI [2,[35][36][37]. These reviews found that there was considerable heterogeneity in the outcomes of HIV prevention interventions in this population.…”

Section: Introductionmentioning

confidence: 99%

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Intervening for HIV prevention and mental health: a review of global literature

et al. 2021

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Introduction Numerous effective HIV prevention options exist, including behaviour change interventions, condom promotion and biomedical interventions, like voluntary medical male circumcision and pre‐exposure prophylaxis. However, populations at risk of HIV also face overlapping vulnerabilities to common mental disorders and severe mental illness. Mental health status can affect engagement in HIV risk behaviours and HIV prevention programmes. We conducted a narrative review of the literature on HIV prevention among key populations and other groups vulnerable to HIV infection to understand the relationship between mental health conditions and HIV prevention outcomes and summarize existing evidence on integrated approaches to HIV prevention and mental healthcare. Methods We searched five databases for studies published from January 2015 to August 2020, focused on HIV prevention and mental health conditions among key populations and individuals with serious mental illness. Studies were included if they evaluated an HIV prevention intervention or assessed correlates of HIV risk reduction and included assessment of mental health conditions or a mental health intervention. Results and discussion We identified 50 studies meeting our inclusion criteria, of which 26 were randomized controlled trials or other experimental designs of an HIV prevention intervention with or without a mental health component. Behaviour change interventions were the most common HIV prevention approach. A majority of studies recruited men who have sex with men and adolescents. Two studies provided distinct approaches to integrated HIV prevention and mental health service delivery. Overall, a majority of included studies showed that symptoms of mental disorder or distress are associated with HIV prevention outcomes (e.g. increased risky sexual behaviour, poor engagement in HIV prevention behaviours). In addition, several studies conducted among groups at high risk of poor mental health found that integrating a mental health component into a behaviour change intervention or linking mental health services to combination prevention activities significantly reduced risk behaviour and mental distress and improved access to mental healthcare. Conclusions Evidence suggests that mental health conditions are associated with poorer HIV prevention outcomes, and tailored integrated approaches are urgently needed to address overlapping vulnerabilities among key populations and other individuals at risk.

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Section: What Do We Know About Interventions That Address Mental Health In the Context Of Hiv Prevention?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intervening for HIV prevention and mental health: a review of global literature

et al. 2021

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“…Beyond testing, future studies are needed to develop evidencebased HIV prevention approaches tailored for this high-risk group. 33,34 This study has a number of limitations to consider. The implementation of the intervention in a single urban public mental health clinic limits generalizability of the ndings.…”

Section: Discussionmentioning

confidence: 99%

CRANIUM: A quasi-experimental study to improve metabolic screening and HIV testing in community mental health clinics compared to usual care

Hwong

Chagwedera

Thomas

et al. 2022

Preprint

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Background Individuals with serious mental illness often do not receive guideline-concordant metabolic screening and human immunodeficiency virus (HIV) testing, contributing to increased morbidity and premature mortality. This study evaluates the effectiveness of CRANIUM (Cardiometabolic Risk Assessment and treatment through a Novel Integration model for Underserved populations with Mental illness), an intervention to increase metabolic screening and HIV testing among patients with serious mental illness in a community mental health clinic compared to usual care. Methods The study used a quasi-experimental design, implementing the intervention at one community mental health clinic (n = 536 patients) compared to usual care (n = 4,847 patients) in a large urban behavioural health system. Psychiatrists received training in preventive health screening and had access to a primary care consultant, screening and treatment algorithms, patient registries, and a peer support specialist. Outcomes were screening rates of A1c, lipid, and HIV testing post-intervention compared to baseline. Results In the intervention group, there was a statistically significant increase in lipid screening rates from 19.2–25.6% (P = .001) and increase in HIV testing rates from 1.3–15.9% (P < .001). The A1c testing rate increase in the intervention group from 23.7–28.9% was not statistically significant (P = .09). There were no significant changes in screening rates for A1c, lipid, or HIV testing in the usual care group. Conclusions This low-cost, reverse integrated care model targeting community psychiatrist practices had modest effects on increasing preventive care screenings, with the biggest effect seen for HIV testing rates. Additional incentives and structural supports may be needed to further promote screening practices for individuals with serious mental illness.

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“…Thus, less attention to sexual health needs among Black adolescents with mental illnesses has significant public health implications for this understudied group. For example, standardized methods do not exist to screen for sexual health concerns (e.g., risk for HIV/STIs) and develop individualized risk reduction plans during mental health treatment encounters (Wright, Akhtar, Tosh, & Clifton, 2012). Moreover, many mental health treatment programs are not equipped to handle the sexual health needs of their clients (McKinnon, Wainberg, & Cournos, 2001; Solomon et al, 2007).…”

mentioning

confidence: 99%

Addressing Unmet Sexual Health Needs among Black Adolescents with Mental Illnesses

Brawner

Fannin

Reason

et al. 2016

Journal of Black Sexuality and Relationships

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Despite advances in HIV epidemiologic and prevention research, adolescents with mental illnesses remain a historically underserved group with respect to human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention resources. Black adolescents with mental illnesses in particular are a relatively underserved, hidden population in the field of sexual health. Strategies and guidelines are needed to account for underlying psychopathology among Black adolescents with mental illnesses in ways that current models have yet to address. In this paper, we propose several actionable mechanisms to better integrate HIV/STI and mental health related services and activities for sexual health promotion.

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HIV prevention advice for people with serious mental illness

Abstract: The problem of therapeutic efficacy indices. 3. Comparison of the indices and their use [Apercu sur la problematique des indices d'efficacite therapeutique, 3: comparaison des indices et utilisation. Groupe d'etude des Indices d'efficacite].

Cited by 7 publications

References 45 publications

Intervening for HIV prevention and mental health: a review of global literature

Intervening for HIV prevention and mental health: a review of global literature

CRANIUM: A quasi-experimental study to improve metabolic screening and HIV testing in community mental health clinics compared to usual care

Addressing Unmet Sexual Health Needs among Black Adolescents with Mental Illnesses

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