SEXUAL-BEHAVIOR OF HOMELESS MENTALLY-ILL MEN AT RISK FOR HIV

Objective: The authors investigated sexual behaviors related to HIV tr ansmission among homeless mentally ill men in a New York City shelter. A previous study of a similar population found HIV prevalence to be 1 9%. Method: In standardized interviews with 122 melt, data on sexual b ehaviors for the previous 6 months were collected. The frequency and n ature of sexual episodes that may facilitate HIV transmission were exa mined. In addition, sexual risk behaviors among broadly defined diagno stic groups were compared. Results: Of the 222 men, 65 (53%) had sex, 56 with women and 20 with men (11 who had sex with both women and men are counted in each group). The sexually active men, in most cases, ha d only occasional sex (once per month or less). The majority of sexual ly active men-29 (52%) of those who had sex with women and 12 (60%) of those who had sex with men-had sex without a condom and with nonmonog amous partners. Comorbid cocaine abuse or dependence was significantly associated with high-risk sexual behaviors. Conclusions: The majority of these men had sex occasionally or not at all. Nonetheless, because many of them had unprotected sex with nonmonogamous partners, the few sexual episodes may have carried an appreciable risk of HIV transmiss ion. Moreover, men with a comorbid cocaine dependence may represent a group with an especially high risk for sexual HIV transmission. The au thors propose that in this population, preventive interventions could modify the nature, if not the frequency, of sexual episodes.