RISK FOR HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION AMONG PERSONS WITH SEVERE MENTAL ILLNESSES

Individuals diagnosed with a severe mental illness are at significantl y enhanced risk for infection with the human immunodeficiency virus (H IV). To better understand elevated seroprevalence in this population, we review the research literature that has investigated HIV-related ri sk behavior among adults who have a severe and persistent mental illne ss, This review indicates that 54%-74% of adults report that they have been sexually active in the last year with approximately one third re porting two or more partners. Among those who were sexually active, co ndom use was inconsistent. A significant minority (4%-35%) of adults a lso reported a history of injection drug use. Overall, the data indica te that the severely mentally ill engage regularly in practices known to involve increased risk for HIV transmission. We introduce and modif y Fisher and Fisher's (1992) theoretical model to organize the possibl e determinats of HIV-related risk taking among severely mentally ill a dults, and encourage use of this model in the design of behavioral epi demiological and risk reduction studies. We also identify several meth odological challenges to HIV-related research, including problems asso ciated with the use of self-report measures; diagnostic imprecision; a nd participant recruitment and retention. (C) 1997 Elsevier Science Lt d.