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Schizophrenia and Comorbid Human Immunodeficiency Virus or Hepatitis C Virus

Francine Cournos, MD; Karen McKinnon, MA; and Greer Sullivan, MD, MSPH

Published: August 15, 2005

Article Abstract

Patients with schizophrenia are at significantly increased risk for infection with human immunodeficiencyvirus (HIV), hepatitis C virus, or both. Several factors underlie this increased risk, includingsubstance abuse and high-risk sexual behavior. Although being sexually active tends to be less commonamong patients with schizophrenia than among nonpsychotic individuals, patients with schizophreniawho are sexually active are more likely than nonpsychotic individuals to engage in high-riskbehavior. Many patients with schizophrenia have inadequate knowledge about the risks of HIV, butdelivering factual information is not likely, by itself, to bring about behavioral changes that reduce therisk of exposure and transmission. Comorbidity of schizophrenia and life-threatening viral illnessesincurs a worse prognosis for both conditions. Nevertheless, effective pharmacotherapy exists, andantipsychotics and highly active antiretroviral treatments for HIV can be used together successfully.The clinical challenge is to encourage adherence to treatment and to coordinate the clinical servicesneeded to address the diverse psychiatric and medical problems that coexist in this population.

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