Understanding HIV-related risk among persons with a severe and persistent mental illness - Insights from qualitative inquiry

We conducted fetus groups with 36 men and women who were receiving treatmen t for a severe and persistent mental illness (SPMI) to learn more about the social context of their intimate relationships and the psychological antec edents of their sexual decision-making. Qualitative analysis of focus group transcripts indicated that a) sexual activity tended to be unplanned and o ccurred in social networks where HIV risk may be elevated, b) HIV-related k nowledge was superficial and insufficient to guide safer sexual behavior, c ) participants' HIV risk perception was often based upon factors unrelated to their sexual behaviors, and d) communication skills for HIV risk reducti on were poor. We discuss how qualitative methods yielded insights not readi ly available through quantitative approaches and offer recommendations for HIV risk assessment and prevention among persons with an SPMI.