The effectiveness of sexual health interventions for people with severe mental illness: a systematic review

Kaltenthaler, Eva; Pandor, Abdullah; Wong, Ruth

doi:10.3310/hta18010

Cited by 18 publications

(13 citation statements)

References 58 publications

(137 reference statements)

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“…Compared with usual care, two studies [ 28 , 38 ] observed a significant improvement in behavioral skills following sexual assertiveness training (n = 20) [ 38 ] or role-play simulations (n = 408) [ 28 ]. A detailed summary of the results for each included study is available in Kaltenthaler et al [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

Sexual health risk reduction interventions for people with severe mental illness: a systematic review

et al. 2015

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BackgroundDespite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants’ knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness.MethodsThirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence.ResultsThirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies.ConclusionsThere is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the serious consequences of high-risk sexual behaviors, there is an urgent need for well-designed UK based trials, as well as training and support for staff implementing sexual health risk reduction interventions.Trial registrationPROSPERO CRD42013003674.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1448-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Sexual health risk reduction interventions for people with severe mental illness: a systematic review

et al. 2015

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“…For instance, in most people sexual relationships occur in the context of marriage and before marriage pietism is common recommendation as a moral value. However, many individuals with SMIs also suffer from coexisting substance and alcohol abuse, and some problems in establishing stable and sexual relationships . So, the need for sex education has been emphasized by various studies .…”

Section: Introductionmentioning

confidence: 99%

Neglected sexual needs: A qualitative study in Iranian patients with severe mental illness

Raisi

Yahyavi

Mirsepassi

et al. 2018

Perspect Psychiatr Care

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“…Unprotected sexual intercourse has been linked with biological, psychological, social, and contextual determinants often interacting with each other. 8 , 9 Among psychological determinants, mental health (eg, depressive symptoms and substance abuse), 10 negative attitudes towards condom use, 11 and low self-efficacy to adopt protective behavior 12 were shown to correlate with unprotected sex. Self-efficacy or the perceived ability to exert personal control over behavior change 13 is a central construct in empirically validated behavior change theories such as social cognitive theory (SCT) 14 and the Information-Motivation-Behavioral skills model (IMB), 15 and was found to highly correlate with individuals' health behaviors including sexual activity for MSM.…”

Section: Introductionmentioning

confidence: 99%

Implementation and Operational Research

Nöstlinger

Platteau

Bogner

et al. 2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

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The effectiveness of sexual health interventions for people with severe mental illness: a systematic review

Cited by 18 publications

References 58 publications

Sexual health risk reduction interventions for people with severe mental illness: a systematic review

Sexual health risk reduction interventions for people with severe mental illness: a systematic review

Neglected sexual needs: A qualitative study in Iranian patients with severe mental illness

Implementation and Operational Research

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