IMPLEMENTING COGNITIVE-BEHAVIORAL AIDS HIV RISK REDUCTION GROUP INTERVENTIONS IN COMMUNITY MENTAL-HEALTH SETTINGS THAT SERVE PEOPLE WITH SERIOUS MENTAL-ILLNESS/

Previous research has found high levels of HIV seroprevalence and risk behavior among people with severe mental illness living in the commun ity. Risk in this population is associated with high prevalence of unp rotected sex with multiple, casual or high-risk sexual partners; high levels of sexual contact between men with severe mental illness and ot her men use of injection drugs or sexual contact within injection drug user (IDU) social networks elevated rates of alcohol and noninjected drug use, especially the use of crack: cocaine and the exchange of sex for drugs; and patterns of ''survival sex'' to obtain food, money, or a place to stay. A number of theoretical models have been developed t o guide HIV risk behavior change interventions, This paper describes t he theoretical underpinnings of skills-based HIV risk reduction interv entions and the elements critical to successful HIV risk behavior dama ge as delineated by this model, We then discuss how these elements wer e operationalized in an HIV prevention intervention successfully imple mented in urban community mental health clinics serving people with me ntal illness. Effective, theory-driven HIV prevention interventions ca n be successfully incorporated into the daily service life of communit y-based mental health clinics.