Undertreatment of human immunodeficiency virus in psychiatric inpatients: a cross-sectional study of seroprevalence and associated factors

Background: The aims of this study were to evaluate the prevalence of HIV and its associated demographic and clinical factors among psychiatric inpatients of a general hospital. Methods: This was a single-center, observational, cross-sectional study that included patients consecutively admitted to our unit aged 16 years or older and with no relevant cognitive problems. The patients were evaluated using a semistructured interview and an appropriate test for HIV infection. Results: Of the 637 patients who were screened, 546 (86%) who consented to participate were included in the analyses. Twenty-five (4.6%, 95% confidence interval [CI] 3.0-6.8) patients were HIV-positive. The prevalence was higher among patients with substance misuse (17.4%, 95% CI 9.7-28.8). All except one of the 25 patients knew of their seropositive condition prior to participation in the study. Only 14 (56%) of the 25 seropositive patients had previously received pharmacological treatment for their infection. According to the multiple logistic regression analysis, the likelihood of HIV infection was lower in patients with higher levels of education and higher among patients who were single, had history of intravenous drug use, and had an HIV-positive partner, particularly if they did not use condoms. Among the patients with HIV infection, 18 (72%) had a history of suicide attempts compared with 181 (34.7%) of the patients without HIV infection (relative risk 2.1, 95% CI 1.6-2.7; P<0.001). Conclusion: HIV infection is highly prevalent in patients admitted to a psychiatric unit, especially those with a diagnosis of substance misuse. Seropositive patients show very poor treatment adherence. The risk of suicide seems to be very high in this population. Implementing interventions to reduce the suicide risk and improve adherence to antiretroviral therapy and psychotropic medications seems crucial.

Cybervictimization by cyberbullying: children at risk and children as risk

Cybercrime in general derives from a series of events and factors that converge to foster this phenomenon. After an introduction, the reader will find four chapters. The first one provides a contextualization with background information. The changes in socioeconomic life and the accessibility and reach of the new technologies are assessed. The focus is set on the use of the internet and its far-reaching implications including the responses of national and international institutions. Nowadays, the internet is the window to current affairs whereby the social world is projected, and this idea becomes clear throughout the text. The second chapter deals with factors of patterns of cyberbullying. The third one is concentrated on the impact of cyberbullying and the concept of harm. The final one tackles the possibilities of recovery and resilience. All this allows us to draw some general conclusions. The work ends with a list of references and several annexes that help to understand in depth some of the points discussed throughout the text.

The Relationship between Risk and Expected Return in Europe

Revised: 2006-07