PATTERNS, PREDICTORS AND GENDER DIFFERENCES IN HIV RISK AMONG SEVERELY MENTALLY-ILL MEN AND WOMEN

A number of studies have established high human immunodeficiency virus (HIV) seroprevalence among severely mentally ill men and women living in large urban areas. Much less research has characterized the patter ns of risk behavior that contribute to elevated vulnerability to HIV/A IDS among the mentally ill, as well as psychological, situational, and gender-related influences on risk in this population. One-hundred thi rty-four severely mentally ill men and women who reported sexual activ ity outside of an exclusive relationship or with high-risk partners co mpleted an extensive measure battery concerning HIV risk. Knowledge ab out HIV was low and sexual risk behavior levels were high in the sampl e. On average, condoms were used in only 32% of intercourse occasions in the past three months, and nearly one-half of participants reported multiple sexual partners in the same period. Patterns common in the s ample were sex associated with substance use; coerced sex, bartering s ex for money, food, clothes, or a place to stay; and sex with injectio n drug user partners. Factors predictive of greater risk were being fe male, presently being in a relationship, perceiving oneself to be at r isk, high levels of alcohol use, and weak risk reduction behavioral in tentions; Mental health programs serving severely mentally ill men and women are reaching a population at elevated risk for contracting HN i nfection, and can serve as a venue for targeted HIV prevention interve ntions.