AIDS/HIV risk behavior among the chronic mentally ill

Abstract

These findings underscore the need for AIDS risk assessment, counseling, and prevention programs for the chronic mentally ill.

Seriously Mentally Ill Women’s Safer Sex Behaviors and the Theory of Reasoned Action

“…Nine items adapted from a safer sex social norms scale in Kelly et al (1992) were used to measure perceived normative acceptance of safer sex practices. Perceived social norms are conceptualized as an individual’s beliefs about peer and partner acceptance and practices of safer sexual behaviors.…”

“…Four items adapted from Kelly et al (1992) were used to assess participants’ intentions to use condoms or to avoid unprotected sex: “I will use a condom the next time I have sex,” “I will refuse to have sex if a condom is not available,” “I will talk about HIV/AIDS with a sexual partner,” and “I will insist on condom use, even in the heat of the moment.” Respondents used a 6-point scale to indicate level of agreement with each statement (1 = strongly disagree to 6 = strongly agree). Each participant’s overall safer sex intentions score was the sum of his or her scores on the 4 individual items (Cronbach’s alpha = .82).…”

“…As a “rationalistic” model, the Theory of Reasoned Action may have limited applicability to seriously mentally ill people, who face unique challenges due to their psychiatric conditions. Cognitive deficits, impaired judgment, affective instability, and poor impulse control can lead to unsafe sexual and drug use behaviors among persons with mental illness (Kelly et al, 1992). Self-efficacy for HIV risk reduction, or perceived behavioral control, may be particularly important for mentally ill women because the circumstances in which sexual activity occurs likely have a strong influence on their decisions and require high self-efficacy to overcome.…”

High Levels of Concomitant Behavioral Health Disorders Among Patients Presenting for HIV Non-occupational Post-exposure Prophylaxis at a Boston Community Health Center Between 1997 and 2013

“…Mental illness has been shown to be associated with behaviors that increase HIV transmission risk in multiple studies since the early years of the epidemic. Such behaviors include having multiple sex partners, unprotected anal sex, inconsistent condom use, trading sex for money, drugs, or a place to stay, casual sexual encounters, sexual activity after use of drugs, drug dependence in general, and decreased sexual self-efficacy (2–7). Studies have additionally demonstrated that HIV is more prevalent among patients with severe mental illness in various settings (8–10).…”

“…Studies have additionally demonstrated that HIV is more prevalent among patients with severe mental illness in various settings (8–10). People who become HIV-infected in the United States are more likely to report having multiple sex partners, exchanging sex for drugs or money or housing, stimulant or alcohol use during sexual activity, inconsistent condom use, and casual sexual encounters than those who are not infected (2,3,11,12). While nonoccupational post-exposure prophylaxis (nPEP) has long been recommended for biomedical HIV prevention after high-risk exposures (13), nPEP is underutilized (14–17).…”