Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness

We examined the prevalence and correlates of human immunodeficiency virus ( HIV)/acquired immunodeficiency syndrome (AIDS) risk behaviors in a large sa mple of severely mentally ill (SMI) patients. Risk levels were correlated w ith demographic factors, diagnosis, symptom severity, trauma history, post- traumatic stress disorder (PTSD), substance use disorder (SUD), and sexual orientation. SMI clients from urban and rural settings (N = 275) were asses sed regarding HIV/ AIDS risk behaviors, and hypothesized risk factors. Pati ents exhibited substantial levels of risky behavior, particularly sexual ri sk. Correlates of increased risk included SUD, trauma, male homosexual orie ntation, younger age, and symptom severity. Structural equation modeling id entified SUD and sexual orientation as the primary determinants of both dru g and sexual risk behavior. We conclude that specific illness related varia bles appear to have less impact on risk behavior among people with SMI than previously hypothesized. Substance abuse prevention and treatment may be t he most effective means of reducing HIV risk in this population. Copyright (C) 2001 by W.B. Saunders Company.