Risk of HIV infection in psychiatrically ill patients

The growing spread of HIV infection and AIDS incidence has led the medical milieu to increase efforts in the study of the at-risk population and in the development of prevention programmes. Nevertheless, little attention has been focused on psychiatric patients as a vulnerable and disadvantaged segment of the population with high risk of HIV infection. In fact, several studies in the last years have shown that high-risk behaviour, especially intravenous drug abuse and non-protected at-risk sexual intercourse, is reported by 20-50% of psychiatric patients, particularly those affected by bipolar disorders and schizophrenia. The prevalence of HIV infection has also been found to be higher in psychiatric patients than in the general population. In general, only a proportion (15-50%) of HIV-positive psychiatric patients have knowledge about their serological status, while the others do not know that they have been infected. Preliminary studies show that educational programmes specifically developed for psychiatric patients improved knowledge of HIV infection and reduced the patients' HIV-risk behavior. Specific intervention strategies should also be known when dealing with mentally ill HIV-positive patients. Open problems and further issues to be addressed by future research are discussed.