HIV/AIDS risk behaviour in South African schizophrenia patients

Initially the risk of HIV in people with severe mental illness (SMI) was grossly underestimated, but comparisons with the general population have in fact revealed higher infection rates in this particular group. Not only are patients with SMI sexually active but it has also been demonstrated that this group and especially patients with schizophrenia are less knowledgeable about HIV risk behaviours than the general population. Currently no data concerning the participation in and knowledge of HIV/AIDS risk behaviours by South African schizophrenic patients is available.

Patients with schizophrenia and a control-group were recruited from community clinics in the Western Cape, South Africa, whereafter 43 from each group were matched (race, age, sex). The patient group was subjected to a structured clinical interview and both groups completed the AIDS Risk Behaviour Assessment (ARBAQ) and Knowledge (ARBKQ) Questionnaires.

Comparatively, significant knowledge deficits could be demonstrated for the patient group in overall terms (p<0.001) as well as for five specific items (all p<0.05) on the ARBKQ. Furthermore, 10% of the patients believed that the depot antipsychotic injection placed individuals at risk for contracting HIV. Both groups also admitted participation in various high risk sexual behaviours.

Our results suggest that patients with schizophrenia should be a target group when developing AIDS prevention programmes. In order to identify particularly at risk individuals, a comprehensive risk behaviour assessment should form part of the psychiatric interview.