Improved Training Needed for Sexual Health Promotion, HIV Prevention in Individuals With Mental Health Problems

New survey results show that mental health workers need more training to provide skills for health promotion regarding sexual health and HIV in individuals with serious mental health problems, according to research published in the Journal of Clinical Nursing.¹

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Individuals with serious mental illness are at a heightened risk of HIV and other sexually-transmitted infections (STIs).¹ Alcohol and other drug use disorders are among the most common mental disorders among HIV-infected individuals. Epidemiological studies also suggest that the majority of HIV-infected individuals will suffer from other psychiatric disorders, including anxiety, depression, or psychosis.²

Mental health workers play an important role in promoting sexual health in this population, but it is unclear how they perceive their work in this space and whether they have the tools and knowledge to deliver sexual health promotion.¹

Mental health interventions are a critical part of the global response to HIV, with multiple potential roles for psychiatrists and other mental health professionals. These include diagnosing and treating psychiatric and substance use disorders related to HIV risk-taking behaviors; performing differential diagnosis and treatment of psychiatric disorders that co-occur with HIV infection; assisting with adherence to various treatments; and helping manage psychosocial problems such as disclosure of HIV-positive status, adjustment to the diagnosis and illness, and access to services such as housing and financial assistance.²

In the study, investigators distributed a questionnaire to 650 mental health workers in a London National Health Service mental health service. The goal was to investigate the attitudes, knowledge, and reported practice of mental health workers regarding HIV and other STIs in individuals with serious mental illnesses. The survey achieved a response rate of 44%.¹

According to the results, workers reported positive attitudes to sexual health promotion and were knowledgeable about risk behaviors and risk factors for HIV infection. Adherence to glove wearing was also good and was predicted by those who had drug and alcohol training.¹

However, participants’ reported poor knowledge about HIV/AIDS in individuals with schizophrenia and most respondents said they were not engaged in sexual health promotion activities among individuals with serious mental illness. Clinical experience and knowledge of risk factors was predicted by previous health promotion training.¹

The investigators said these findings could help with the development of effective interventions to reduce risky sexual behavior and enable clinicians to adequately address these issues.¹ Some key roles for mental health professionals in the public health response to HIV include further elucidating mental health-related factors involved in HIV transmission; advocating for substance abuse treatment; developing and implementing HIV behavioral prevention interventions; and treating the mental health aspects of HIV and AIDS.

On a more individual basis, clinicians can foster non-judgmental prevention, educate patients about risks and associated co-morbidities, and assist in managing the psychosocial impact of HIV and other STIs on patients and their families.²

REFERENCES

1. Hughes E, Gray R. HIV prevention for people with serious mental illness: a survey of mental health workers’ attitudes, knowledge, and practice. Journal of Clinical Nursing. 2009. doi:10.1111/j.1365-2702-2007-02227.x
2. Cournos F, McKinnon K, Wainberg M. What can mental health interventions contribute to the global struggle against HIV/AIDS? World Psychiatry. 2005;4(3):135-141. PMID:16633531