DIAGNOSIS, HEALTH BELIEFS, AND RISK OF HIV-INFECTION IN PSYCHIATRIC-PATIENTS

Objective, The study examined behavioral and cognitive factors that ma y place mentally ill persons at increased risk of infection by the hum an immunodeficiency virus (HIV). Methods: Sixty-one patients consecuti vely admitted to a psychiatric inpatient unit of a public general hosp ital completed questionnaires focused on their knowledge about AIDS an d their sexual practices. They also participated in a structured inter view to assess how their beliefs about health related to changes in he alth behaviors. Responses of the psychiatric Patients, of whom 54.5 pe rcent were men and 61.5 percent were black, were categorized by diagno sis (schizophrenia, bipolar affective disorder, and depression) and we re compared with responses Of a control group of 32 patients with no i dentified psychiatric disorder who had been treated in the hospital's medical emergency room. Results: Trends in the data suggested that the psychiatric patients were more likely than the control subjects to en gage in high-risk sexual behaviors. Psychiatric patients with differen t diagnoses appeared to engage in different kinds of high-risk behavio rs. Whereas control subjects seemed inclined to change their behaviors as their knowledge about HIV increased, schizophrenic patients appear ed willing to change their behavior only if they believed their behavi or could really make a difference in whether they would become infecte d. Conclusions: The relationship between specific psychiatric symptoms , knowledge about HIV, and factors influencing behavior need to be mor e thoroughly examined so that clinicians can develop interventions to reduce the risk of HIV infection in mentally ill persons.