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• W2770956876 abstract "We agree with Nathan Hodson and Susan Bewley that the social exclusion of people with severe mental illness is associated with intimate partner and sexual violence as an important factor among others that contribute to HIV risk behaviours. Even without the presence of violence, mental illness stigma, and especially “relationship discrimination” stigma has been shown to be associated with HIV sexual risk behaviours.1Elkington KS Hackler D Walsh TA et al.Perceived mental illness stigma, intimate relationships, and sexual risk behavior in youth with mental illness.J Adolesc Res. 2013; 28: 378-404Crossref PubMed Scopus (18) Google Scholar, 2Elkington KS McKinnon K Mann CG Collins PY Leu CS Wainberg ML Perceived mental illness stigma and HIV risk behaviors among adult psychiatric outpatients in Rio de Janeiro, Brazil.Community Ment Health J. 2010; 46: 56-64Crossref PubMed Scopus (23) Google Scholar TasP or treatment as prevention not only suppresses viral load for public health purposes,3Centers for Disease Control and PreventionInformation from CDC's Division of HIV/AIDS Prevention.https://www.cdc.gov/hiv/library/dcl/dcl/092717.htmlDate: September 27, 2017Google Scholar it also provides people with HIV the freedom to refocus their sexual lives away from a sick vector role and view it as a healthy activity. Thus, both those with HIV with undetectable viral loads and their sexual partners benefit from TasP. TasP can facilitate the destigmatisation of people living with HIV. The main point of our Comment is that the existing global efforts to end HIV, hepatitis B virus, and hepatitis C virus are not reaching people with severe mental illness; public psychiatric care systems stigmatise their patients by not participating in these efforts. Although probably unintended, that can be considered an iatrogenic health-care system stigma against people with severe mental illness and their sexual partners. We declare no competing interests. Ending HIV, hepatitis B, and hepatitis C: what about people with severe mental illness?HIV, hepatitis B (HBV), and hepatitis C (HCV) are preventable serious blood-borne infections. Early detection and accessible and user-friendly treatments improve prognosis, cure (for HCV), and prevent further transmission. 30 years of previous studies in a range of population samples have suggested that severe mental illness is a risk factor for contracting blood-borne viruses (BBVs).1 In The Lancet Psychiatry, Clarissa Bauer-Staeb and colleagues2 confirm the elevated risk for BBVs experienced by individuals with severe mental illness in a total population study of Sweden, finding that the odds of HIV were 2·57 (95% CI 2·25–2·94, p<0·0001) times higher in people with severe mental illness than in the general population, whereas the odds of HBV were 2·29 (2·09–2·51, p<0·0001) times higher and the odds of HCV were 6·18 (5·98–6·39, p<0·0001) times higher. Full-Text PDF Open AccessSocial exclusion and human rights at the intersection of HIV and severe mental illnessIn their comprehensive Comment, Wainberg and Dixon1 described potential policy implications of the increased prevalence of HIV among people with severe mental illness. HIV and human rights frequently collide and particular caution is required when considering matters of cause and consequence in an already stigmatised and socially excluded population. Full-Text PDF" @default.
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• W2770956876 title "Social exclusion and human rights at the intersection of HIV and severe mental illness – Author's Reply" @default.
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• W2770956876 doi "https://doi.org/10.1016/s2215-0366(17)30439-x" @default.
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