HIV prevention with people with serious mental illness: Staff training and institutional attitudes.

Challenges to HIV prevention in psychiatric settings: Perceptions of South African mental health care providers

“…The attitudes of mental care health providers (MHCPs) to sexual relations and HIV among people with SMI continue to influence the extent to which these issues are addressed in care settings (Collins, 2001;Herman, Kaplan, Satriano, Cournos, & McKinnon, 1994;Wright & Martin, 2003). North American studies suggest that lack of knowledge, stigmatizing ideas and institutional barriers have limited providers' readiness to respond to HIV prevention needs in mental health settings (Herman et al, 1994;Satriano, Rothschild, Steiner, & Oldham, 1999;Walkup, Satriano, Hansell, & Olfson, 1998).…”

“…North American studies suggest that lack of knowledge, stigmatizing ideas and institutional barriers have limited providers' readiness to respond to HIV prevention needs in mental health settings (Herman et al, 1994;Satriano, Rothschild, Steiner, & Oldham, 1999;Walkup, Satriano, Hansell, & Olfson, 1998). Providers' age, sex, sexual orientation, and clinical experience working with HIV have been linked to their comfort in addressing HIV in some mental health care settings (Wright & Martin, 2003).…”

HIV, STD, and Sexual Risk Reduction for Individuals with a Severe Mental Illness: Review of the Intervention Literature

“…First, patients may be confused, have cognitive processing difficulties, or be unable to articulate their thoughts [67], which may interfere with their ability to attend to, understand, or process information, and may make it difficult for them to participate actively and consistently in sexual risk reduction interventions. Second, sexual risk reduction interventions for individuals with SMI are often delivered in the institutions in which the individuals live and/or receive counseling, and a lack of institutional or staff support may hinder these interventions [37]. Some staff may be uncomfortable with the topic of sexual behavior, or may be concerned that talking about sex will lead to increased sexual behavior; others may assume, incorrectly as this review shows, that patients cannot benefit from the intervention [61].…”

“…If the intervention delivery occurs while individuals are in an inpatient setting, and they are released during the intervention follow-up period, the environment will change, making it more challenging to evaluate intervention effectiveness [37]. Additionally, if patients are in an inpatient setting or in other settings, such as a day treatment program, where they spend a lot of time with other study participants, random assignment may not be effective because of the interaction between patients assigned to different groups [37].…”

“…However, the majority of these programs focus on acquisition of skills, including selfmanagement skills, condom use skills, and assertiveness or communication skills [32][33][34][35][36][37][38][39][40][41]. Selfmanagement is often addressed through discussion of personal triggers and through problemsolving training; condom use skills are addressed through condom use demonstration and practice; and assertiveness or communication skills are often addressed through role-play scenarios.…”