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Individual and Treatment Setting Predictors of HIV/AIDS Knowledge Among Psychiatric Patients and Their Implications In a National Multisite Study in Brazil

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Abstract

The objective of this study is to measure HIV/AIDS knowledge among patients with mental illness in Brazil and to examine individual and treatment setting predictors of knowledge. We conducted a cross-sectional national multicenter study among 2,475 patients in 26 randomly selected mental health institutions throughout Brazil. We used Item Response Theory to standardize knowledge scores and multilevel multiple linear regression to determine the effect of individual and treatment setting characteristics on standardized knowledge score. Schizophrenia was the main diagnosis (48%) of participants. Mean knowledge score was 6.78 (range 1–10). Treatment setting characteristics were not associated with knowledge scores. Higher HIV/AIDS knowledge scores were significantly associated with a history of sexually transmitted disease (STD), previous HIV testing and consistent condom use; lower HIV/AIDS knowledge scores were significantly associated with specific sociodemographic, psychiatric, and HIV risk-perception factors. Psychiatric patients in Brazil lag behind the general population with knowledge scores comparable to those of nearly a decade ago. The mental health system in Brazil and elsewhere must consider strategies beyond dispensing information, for preventing HIV/AIDS transmission in the psychiatric population.

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References

  • Aruffo, A. F., Coverdale, J. H., Chacko, R. C., et al. (1990). Knowledge about AIDS among womem psychiatric outpatients. Hospital & Community Psychiatry, 41, 326–328.

    CAS  Google Scholar 

  • Baer, J. W., Dwyer, P., & Lewitter-Koehler, S. (1988). Knowledge about AIDS among psychiatric inpatients. Hospital & Community Psychiatry, 39, 986–988.

    Google Scholar 

  • Baker, F. B. (2001). The basics of item response theory. Boston: Lawrence Rudner.

    Google Scholar 

  • Bartholomew, D. J., Steele, F., Moustaki, I., & Galbraith, J. I. (2002). The analysis and interpretation of multivariate data for social scientists. Boca Raton: Chapman & Hall.

    Google Scholar 

  • Berkman, A., Cerwonka, E., Sohler, N., & Susser, E. (2006). A randomized trial of a brief HIV risk reduction intervention for men with severe mental illness. Psychiatric Services, 57, 407–409.

    Article  PubMed  Google Scholar 

  • Bonolo, P. F., Cesar, C. C., Acurcio, F. A., Ceccato, M. G. B., Padua, C. A. M., Alvares, J., et al. (2005). Non-adherence among patients initiating antiretroviral therapy: a challenge for health professionals in Brazil. AIDS, 19(Suppl 4), S5–S13.

    Article  Google Scholar 

  • Campos, L. N., Guimarães, M. D., Carmo, R. A., Melo, A. P. S., Oliveira, H. N., Elkington, K., et al. (2008). HIV, syphilis, and hepatitis B and C prevalence among patients with mental illness: A review of the literature. Cadernos Saúde Pública, 24(Suppl 4), S607–S620.

    Google Scholar 

  • Carey, M. P., Carey, K. B., & Kalichman, S. C. (1997a). Risk for human immunodeficiency virus (HIV) infection among persons with severe mental illnesses. Clinical Psychology Revision, 17, 271–291.

    Article  CAS  Google Scholar 

  • Carey, M. P., Carey, K. B., Weinhardt, L. S., & Gordon, C. M. (1997b). Behavioral risk for HIV infection among adults with a severe and persistent mental illness: Patterns and psychological antecedents. Community Mental Health Journal, 33, 133–142.

    Article  CAS  PubMed  Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., Schroder, K. E. E., & Vanable, P. A. (2004). Reducing HIV risk behavior among adults receiving outpatient psychiatric treatment: Results from a randomized controlled trial. Journal of Consulting and Clinical Psychology, 72, 252–268.

    Article  PubMed  Google Scholar 

  • Cates, J. A., & Graham, L. L. (1993). HIV and serious mental illness: Reducing the risk. Community Mental Health Journal, 29, 35–47.

    Article  CAS  PubMed  Google Scholar 

  • Chuang, H. T., & Atkinson, M. (1996). AIDS knowledge and high-risk behaviour in the chronic mentally ill. Canadian Journal of Psychiatry, 41, 269–272.

    CAS  Google Scholar 

  • Cournos, F., & McKinnon, K. (1997). HIV seroprevalence among people with severe mental illness in the United States: A critical review. Clinical Psychological Revision, 17, 259–269.

    Article  CAS  Google Scholar 

  • Embretson, S. E., & Reise, S. P. (2000). Item response theory for psychologists. Mahwah, New Jersey: Lawrence Erlbaum Associates, Publishers.

    Google Scholar 

  • Ferreira, M. P. (2008). Knowledge, risk perception on HIV/AIDS by Brazilian population, 1998 and 2005. Revista de Saude Publica, 42(Suppl 1), 65–71.

    PubMed  Google Scholar 

  • Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111, 455–474.

    Article  CAS  PubMed  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & Mchugh, P. R. (1975). Minimental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.

    Article  CAS  PubMed  Google Scholar 

  • Grassi, L., Peron, L., Ferri, S., & Pavanati, M. (1999). HIV-related risk behavior among Italian psychiatric inpatients. Comprehensive Psychiatry, 40, 126–130.

    Article  CAS  PubMed  Google Scholar 

  • Grassi, L., Biancosino, B., Righi, R., Finotti, L., & Perón, L. (2001). Knowledge about HIV transmission and prevention among Italian patients with psychiatric disorders. Psychiatric Services, 52, 679–681.

    Article  CAS  PubMed  Google Scholar 

  • Guimarães, M. D. C., Oliveira, H. N., Campos, L. N., Santos, C. A., Gomes, C. E. R., Oliveira, S. B., et al. (2008). Reliability and validity of a questionnaire on vulnerability to sexually transmitted infections among adults with chronic mental illness—PESSOAS. Brazilian Journal of Psychiatry, 30, 55–59.

    PubMed  Google Scholar 

  • Guimarães, M. D. C., Campos, L. N., Melo, A. P. S., Carmo, R. A., & Machado, C. J. (2009). Prevalence of HIV, syphilis, hepatitis B and C among adults with chronic mental illness: A national multicenter study in Brazil. Brazilian Journal of Psychiatry, 31, 43–47.

    PubMed  Google Scholar 

  • Kalichman, S. C., Kelly, J. A., Johnson, J. R., & Bulto, M. (1994). Factors associated with risk for HIV infection among chronic mentally ill adults. American Journal of Psychiatry, 151, 221–227.

    CAS  PubMed  Google Scholar 

  • Kalichman, S. C., Carey, M. P., & Carey, K. B. (1996). Human immunodeficiency virus (HIV) risk among the seriously mentally ill. Clinical Psychological: Science Practice, 3, 130–143.

    Article  Google Scholar 

  • Kalichman, S., Malow, R., De’vieux, J., Stein, J. A., & Piedman, F. (2005). HIV risk reduction for substance using seriously mentally ill adults: Test of the information-motivation-behavior skills (IMB) model. Community Mental Health Journal, 41, 277–290.

    Article  PubMed  Google Scholar 

  • Katz, R. C., Watts, C., & Santman, J. (1994). AIDS knowledge and high risk behaviors in the chronic mentally ill. Community Mental Health Journal, 30, 395–402.

    Article  CAS  PubMed  Google Scholar 

  • Kelly, J. A., Murphy, D. A., Bahr, G. R., Brasfield, T. L., Davis, D. R., Hauth, A. C., et al. (1992). AIDS/HIV risk behavior among the chronic mentally ill. American Journal of Psychiatry, 149, 886–889.

    CAS  PubMed  Google Scholar 

  • Kelly, J. A., McAuliffe, T. L., Sikkema, K. J., Murphy, D. A., Somlai, A. M., Mulry, G., et al. (2007). Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. Psychiatric Services, 48, 1283–1288.

    Google Scholar 

  • Koen, L., Niehaus, D. J. H., & Emsley, R. A. (2007). Negative symptoms and HIV/AIDS risk-behavior knowledge in schizophrenia. Psychosomatics, 48, 128–134.

    Article  PubMed  Google Scholar 

  • McDermott, B. E., Sautter, F. J., Winstead, D. K., & Quirk, T. (1994). Diagnosis, health beliefs, and risk of HIV infection in psychiatric patients. Hospital & Community Psychiatry, 45, 580–585.

    CAS  Google Scholar 

  • Mckinnon, K., Cournos, F., Sugden, R., Guido, J. R., & Herman, R. (1996). The relative contributions of psychiatric symptoms and AIDS knowledge to HIV risk behaviors among people with severe mental illness. Journal of Clinical Psychiatry, 57, 506–513.

    CAS  PubMed  Google Scholar 

  • Mckinnon, K., Cournos, F., Sugden, R., Guido, J. R., Herman, R., Satriano, J., et al. (1999). Aids-related services and training in outpatient mental health care agencies in New York. Psychiatric Service, 50, 1225–1228.

    CAS  Google Scholar 

  • Meade, C. S., & Sikkema, K. J. (2005). HIV risk behavior among adults with severe mental illness: A systematic review. Clinical Psychological Review, 25, 433–457.

    Article  Google Scholar 

  • Melo, A. P. S., Acúrcio, F. A., Cherchiglia, M. L., Veloso, C. C. G., Guimarães, M. D. C. (2007). Avaliação de serviços de saúde mental: assistência e prevenção às doenças sexualmente transmissíveis no contexto do Projeto PESSOAS. Revista Médica de Minas Gerais, 17(1/2 Suppl. 4): S240–S248.

    Google Scholar 

  • Ministry of Health—Brazil. (2000). National program for STDs and AIDS. Comportamento sexual da população brasileira e percepções do HIV/aids. Série avaliação No. 4. Brasília: Ministério da Saúde.

  • Ministry of Health—Brazil. (2005). National program for STDs and AIDS. Positive response: Experiences of the Brazilian AIDS program. Brasılia, Brazil: Ministry of Health of Brazil. Retrieved July 23, 2006, from http://www.aids.gov.br/final/biblioteca/resposta/resposta_2005.pdf.

  • Ministry of Health—Brazil (2006a). National program for STDs and AIDS. Pesquisa entre Conscritos do Exército Brasileiro 1996–2002: Retratos do comportamento de risco do jovem brasileiro à infecção pelo HIV/Ministério da Saúde, Secretaria de Vigilância em Saúde, Programa Nacional de DST e Aids. Brasília: Ministério da Saúde. 128p. Série Estudos Pesquisas e Avaliação no. 2.

  • Ministry of Health—Brazil. (2006b). National program for STDs and AIDS. Pesquisa de Conhecimento Atitudes e Práticas na População Brasileira de 15 a 54 anos, 2004/Secretaria de Vigilância em Saúde, Programa Nacional de DST e Aids.—Brasília: Ministério da Saúde. 175p.

  • Noguchi, K., Albarracı′n, D., Durantini, M. R., & Glasman, L. R. (2007). Who participates in which health promotion programs? A meta-analysis of motivations underlying enrollment and retention in HIV-prevention interventions. Psychological Bulletin, 133, 955–975.

    Article  PubMed  Google Scholar 

  • Ogunsemi, O. O., Lawal, R. A., Okulate, G. T., Alebiosu, C. O., & Olatawura, M. O. (2006). A comparative study of HIV/AIDS: The knowledge, attitudes, and risk behaviors of schizophrenic and diabetic patients in regard to HIV/AIDS in Nigeria. Medscape Journal of Medicine, 8, 42.

    Google Scholar 

  • Oliveira, H. N., Machado, C. J., Campos, L. N., Acurcio, F. A., Guimarães, M. D. C. (2008). Avaliação da confiabilidade de entrevista aplicada a indivíduos com transtornos mentais: Projeto PESSOAS. Revista Médica de Minas Gerais, 18(4) Suppl. 4:S40–S45.

    Google Scholar 

  • Otto-Salaj, L., Kelly, J. A., Stevenson, L. Y., Hoffmann, R., & Kalichman, S. C. (2001). Outcomes of a randomized small group HIV prevention intervention trial for people with serious mental illness. Community Mental Health Journal, 37, 123–144.

    Article  CAS  PubMed  Google Scholar 

  • Pascom, A. R. P., Barbosa, Jr. A., Szwarcwald, C. L. (2005). Diferenças regionais nas práticas sexuais e comportamentos relacionados à transmissão do HIV. IN: Brasil. Ministério da Saúde. Secretaria de Vigilância Saúde. Programa Nacional de DST e Aids. Pesquisa de Conhecimento Atitudes e Práticas na População Brasileira de 15 a 54 anos. Secretaria de Vigilância Saúde, Programa Nacional de DST e Aids.—Brasília: Ministério da Saúde, 2005.

  • Pinto, D. S., Mann, C. G., Wainberg, M., Mattos, P., & Oliveira, S. B. (2007). Sexuality, vulnerability to HIV, and mental health: An ethnographic study of psychiatric institutions. Cadernos de Saúde Pública, 23, 2224–2233.

    Article  Google Scholar 

  • Sheeran, P., Abraham, C., & Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: A meta- analysis. Psychological Bulletin, 125, 90–132.

    Article  CAS  PubMed  Google Scholar 

  • Strauss, J. L., Bosworth, H. B., Stechuchak, K. M., Meador, K. M., & Butterfield, M. I. (2006). Knowledge and risks of human immunodeficiency virus Transmission among veterans with severe mental illness. Military Medicine, 171, 325–330.

    PubMed  Google Scholar 

  • Sullivan, G., Koegel, P., Kanouse, D. E., Cournos, F., McKinnon, K., Young, A. S., et al. (1999). HIV and people with serious mental illness: The public sector’s role in reducing HIV risk and improving care. Psychiatric Service, 50, 648–652.

    CAS  Google Scholar 

  • Wainberg (PI), M. L. (2006–2011). RCT of a Brazilian HIV Prevention Intervention for the SMI (Projeto PRISSMA). NIMH R01MH65163: Rio de Janeiro, Brazil.

  • Wainberg, M. L., Gonzalez, M. A., McKinnon, K., Elkington, K. S., Pinto, D., Mann, C. G., et al. (2007). Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness. Social Science and Medicine, 65, 296–308.

    Article  PubMed  Google Scholar 

  • Wainberg, M., McKinnon, K., Elkington, K., Mattos, P. E., Mann, C. G., Pinto, D. S., et al. (2008). HIV risk behaviors among outpatients with severe mental illness in Rio de Janeiro, Brazil. World Psychiatry, 7, 166–172.

    PubMed  Google Scholar 

  • World Health Organization. (2004). ICD-10: international statistical classification of diseases and related health problems: Tenth revision.—2nd ed. 3 v.

  • Wright, E. R., & Gayman, M. (2005). Sexual networks and HIV risk of people with severe mental illness in institutional and community-based care. AIDS and Behavior, 9, 341–353.

    Article  PubMed  Google Scholar 

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Funding

PN DST/Aids-UNESCO/Brazil.

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Authors and Affiliations

  1. Research Group in Epidemiology and Health Services Evaluation (GPEAS/CNPq), Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Ana Paula Souto Melo, Cibele Comini César, Francisco de Assis Acurcio, Lorenza Nogueira Campos & Mark Drew Crosland Guimarães

  2. State Health Department (FHEMIG), Raul Soares Institute and Teaching Hospital, Belo Horizonte, MG, Brazil

    Ana Paula Souto Melo

  3. Department of Statistics, School of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Cibele Comini César

  4. Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Francisco de Assis Acurcio & Maria das Graças Braga Ceccato

  5. State Health Department, Eduardo de Menezes Hospital, Belo Horizonte, MG, Brazil

    Lorenza Nogueira Campos

  6. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA

    Milton L. Wainberg

  7. New York State Psychiatric Institute, Columbia University, New York, NY, USA

    Karen McKinnon

  8. Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Mark Drew Crosland Guimarães

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  1. Ana Paula Souto Melo
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  2. Cibele Comini César
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  3. Francisco de Assis Acurcio
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  4. Lorenza Nogueira Campos
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  5. Maria das Graças Braga Ceccato
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  6. Milton L. Wainberg
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  7. Karen McKinnon
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  8. Mark Drew Crosland Guimarães
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Correspondence to Ana Paula Souto Melo.

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Melo, A.P.S., César, C.C., de Assis Acurcio, F. et al. Individual and Treatment Setting Predictors of HIV/AIDS Knowledge Among Psychiatric Patients and Their Implications In a National Multisite Study in Brazil. Community Ment Health J 46, 505–516 (2010). https://doi.org/10.1007/s10597-010-9303-7

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  • DOI: https://doi.org/10.1007/s10597-010-9303-7

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