Prevalence of HIV, syphilis, hepatitis B and C among adults with mental illness: a multicenter study in Brazil.
OBJECTIVE
There is evidence that patients with mental illness have increased prevalence of sexually transmitted infections, but data in Brazil are scarce. The objective of this study was to determine the prevalence of HIV, hepatitis C and B, and syphilis among patients with mental illness in Brazil.


METHODS
A multicenter representative sample of adults with mental illness was randomly selected from 26 mental health institutions throughout Brazil. Sociodemographic, sexual behavior and clinical data were obtained from person-to-person interviews and blood was collected for serology testing. Seroprevalence with 95% confidence limits were obtained correcting for sampling scheme.


RESULTS
Of the 2,475 patients interviewed, 2,238 had blood collected. Most participants were sexually active ever (88.8%) or in the last 6 months (61.6%), female (51.9%), and single (66.6%). Half of the sample had less than 5 years of schooling and the mean monthly individual income was low (US$ 210.00). Condom use was very low either during lifetime (8%) or in the last 6 months (16%). Overall seroprevalence were 1.12%, 0.80%, 1.64%, 14.7% and 2.63% for, respectively, syphilis, HIV, HBsAg, anti-HBc and anti-HCV.


CONCLUSIONS
Seroprevalences found were higher than other populations with representative studies in Brazil, with high rates of sexual risk behavior. This is of public health concern, and prevention and care strategies for sexually transmitted infections among psychiatric patients should urgently be implemented by health authorities.
Guimarães
Mark Drew Crosland
MD
Department of Preventive and Social Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. drew@medicina.ufmg.br
Campos
Lorenza Nogueira
LN
Melo
Ana Paula Souto
AP
Carmo
Ricardo Andrade
RA
Machado
Carla Jorge
CJ
Acurcio
Francisco de Assis
Fde A
D015415:Biomarkers; D001938:Brazil / Q000453:epidemiology; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015483:HIV Antibodies / Q000097:blood / Q000276:immunology; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D015528:HIV Seroprevalence; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D011247:Pregnancy; D013587:Syphilis / Q000453:epidemiology*
D015415:Biomarkers; D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies