Sexually transmitted infections, sexual life and risk behaviours of people living with schizophrenia: systematic review and meta-analysis.

IF 3.9 3区医学 Q1 PSYCHIATRY BJPsych Open Pub Date : 2024-05-10 DOI:10.1192/bjo.2024.49

Claudia Aymerich, Borja Pedruzo, Gonzalo Salazar de Pablo, Lander Madaria, Javier Goena, Vanessa Sanchez-Gistau, Paolo Fusar-Poli, Philip McGuire, Miguel Ángel González-Torres, Ana Catalan

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Abstract

Background: Sexually transmitted infections (STIs), along with sexual health and behaviour, have received little attention in schizophrenia patients.

Aims: To systematically review and meta-analytically characterise the prevalence of STIs and sexual risk behaviours among schizophrenia patients.

Method: Web of Science, PubMed, BIOSIS, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, SciELO and Cochrane Central Register were systematically searched from inception to 6 July 2023. Studies reporting on the prevalence or odds ratio of any STI or any outcome related to sexual risk behaviours among schizophrenia samples were included. PRISMA/MOOSE-compliant (CRD42023443602) random-effects meta-analyses were used for the selected outcomes. Q-statistics, I² index, sensitivity analyses and meta-regressions were used. Study quality and publication bias were assessed.

Results: Forty-eight studies (N = 2 459 456) reporting on STI prevalence (including 15 allowing for calculation of an odds ratio) and 33 studies (N = 4255) reporting on sexual risk behaviours were included. Schizophrenia samples showed a high prevalence of STIs and higher risks of HIV (odds ratio = 2.11; 95% CI 1.23-3.63), hepatitis C virus (HCV, odds ratio = 4.54; 95% CI 2.15-961) and hepatitis B virus (HBV; odds ratio = 2.42; 95% CI 1.95-3.01) infections than healthy controls. HIV prevalence was higher in Africa compared with other continents and in in-patient (rather than out-patient) settings. Finally, 37.7% (95% CI 31.5-44.4%) of patients were sexually active; 35.0% (95% CI 6.6-59.3%) reported consistent condom use, and 55.3% (95% CI 25.0-82.4%) maintained unprotected sexual relationships.

Conclusions: Schizophrenia patients have high prevalence of STIs, with several-fold increased risks of HIV, HBV and HCV infection compared with the general population. Sexual health must be considered as an integral component of care.

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精神分裂症患者的性传播感染、性生活和危险行为：系统回顾和荟萃分析。

背景：目的：对精神分裂症患者的性传播感染（STI）以及性健康和性行为进行系统回顾和荟萃分析：方法：系统检索了从开始到2023年7月6日期间的Web of Science、PubMed、BIOSIS、KCI-韩国期刊数据库、MEDLINE、俄罗斯科学引文索引、SciELO和Cochrane中央登记册。纳入的研究报告涉及精神分裂症样本中任何性传播感染的患病率或几率，或任何与性危险行为相关的结果。对所选结果采用符合 PRISMA/MOOSE 标准 (CRD42023443602) 的随机效应荟萃分析。使用了Q统计量、I2指数、敏感性分析和元回归。对研究质量和发表偏倚进行了评估：结果：共纳入了 48 项报告性传播感染发病率的研究（N = 2 459 456）（其中 15 项允许计算几率比例）和 33 项报告性风险行为的研究（N = 4255）。与健康对照组相比，精神分裂症样本的性传播感染率较高，感染艾滋病毒（几率比=2.11；95% CI 1.23-3.63）、丙型肝炎病毒（HCV，几率比=4.54；95% CI 2.15-961）和乙型肝炎病毒（HBV；几率比=2.42；95% CI 1.95-3.01）的风险也较高。与其他大洲相比，非洲的艾滋病毒感染率更高，而且是在住院（而非门诊）环境中。最后，37.7%（95% CI 31.5-44.4%）的患者性生活活跃；35.0%（95% CI 6.6-59.3%）的患者坚持使用安全套，55.3%（95% CI 25.0-82.4%）的患者保持无保护的性关系：精神分裂症患者的性传播感染率很高，感染艾滋病毒、乙肝病毒和丙肝病毒的风险是普通人群的数倍。性健康必须被视为护理的一个组成部分。

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来源期刊

BJPsych Open Medicine-Psychiatry and Mental Health

CiteScore

6.30

自引率

3.70%

发文量

610

审稿时长

16 weeks

期刊介绍： Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.