As people around the world stand in solidarity to recognize the millions living with HIV/AIDS today and the millions of lives lost to HIV/AIDS this World AIDS Day, a report in Psychiatric Services highlights the need to educate women with serious mental illness (SMI) about the risks of the disease.
“Women with serious mental illness (for example, schizophrenia and bipolar disorder) are eight times more likely than women in the general population to contract STDs,” wrote Joseph McEvoy, M.D., of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University and colleagues. These women may also “have limited access to health education and support (for example, safe housing and companionship, access to condoms, and testing for and treatment of STDs) and engage in risky behaviors (for example, multiple partners and unprotected sex) with greater frequency compared with women in the general population.”
To compare women’s understanding of human immunodeficiency virus (HIV) and human papillomavirus (HPV), McEvoy and colleagues asked 89 women with SMI receiving outpatient care at a public mental health center in Augusta, Ga., to complete HIV and HPV questionnaires. The responses of women with SMI were then compared with those of women in the general population (357 responded to an HIV questionnaire; 413 to an HPV questionnaire).
Women with SMI on average answered 64% of the answers correct on the HIV Knowledge Questionnaire. They knew significantly less about HPV compared with HIV, answering 55% of HPV general knowledge, 51% of HPV vaccination, and 40% of HPV testing questions correctly. “Compared with large groups of U.S. women in the general population, our participants knew significantly less about HIV and were significantly less likely to have heard about HPV, HPV vaccination, and HPV testing (all p=0.001),” the authors wrote.
Women with SMI “remain a population at high risk of STDs with life-threatening consequences. They have limited knowledge about these diseases, including strategies to protect themselves,” McEvoy and colleagues concluded. “Research has demonstrated that interventions providing education combined with motivational exercises and assertiveness skills can lead to reduction in risky sexual behaviors in this population. Colocalization of services to provide testing for and treatment of STDs and free condoms within mental health centers [are] likely to offer additional benefit.”
A statement released by the World Health Organization for World AIDS Day calls for continued attention to the most vulnerable populations in the fight against HIV/AIDS: “The world has made significant progress since the late 1990s, but HIV remains a major global public health issue. And like many other major health issues, it faces additional challenges during the COVID-19 pandemic. … HIV prevention, testing, treatment, and care services are all being disrupted particularly in countries with fragile heath systems. The breakdown in essential HIV services due to COVID-19 is threatening lives. Any slowing down in provision of these services will leave many vulnerable populations at greater risk of HIV infection and AIDS-related deaths.”
(Image: iStock/Ponomariova_Maria)
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