HIV Risk Factors for Persons with Serious Mental Illness

Knox, Michael D.; Boaz, Timothy L.; Friedrich, Martha A.; Dow, Michael G.

doi:10.1089/apc.1995.9.192

Cited by 18 publications

(31 citation statements)

References 8 publications

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“…Several recent survey studies have examined sexual risk behavior among the SMI (e.g., Cournos et al, 1994; Carey, Carey, Weinhardt, & Gordon, in press; Kalichman, Kelly, Johnson, & Bulto 1995;Kelly et al, 1992;Knox, Boaz, Friedrich, & Dow, 1994). These studies, which have been conducted across an array of treatment settings (i.e., inpatient, outpatient, homeless shelters) and geographic locations (e.g., Milwaukee, New York City, Syracuse), document that the SMI engage in behaviors that facilitate the transmission of HIV.…”

Section: Introductionmentioning

confidence: 99%

“…The tendency among the SMI to underestimate risk for infection (Knox et al, 1994;Carey et al, in press) is also problematic. SMI patients have reported little fear of AIDS (Sacks, Perry, Graver, Shindledecker, & Hall, 1990), lack of concern about contracting HIV (Hanson et al, 1992;Kelly et al, 1992), and perception of personal risk for infection ranging from none to low (Carey et al, in press).…”

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confidence: 99%

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HIV risk reduction for the seriously mentally ill: Pilot investigation and call for research

Weinhardt

Carey

1997

Journal of Behavior Therapy and Experimental Psychiatry

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Research indicates that people with serious mental illnesses (SMI; e.g., schizophrenia, schizoaffective disorder, bipolar disorder) are at enhanced risk for infection with the human immunodeficiency virus (HIV). To decrease this risk, we piloted a six-session HIV-risk reduction intervention for two single-gender groups (9 women, 8 men; M age = 39.8 years) of SMI outpatients. The intervention and assessment were based on the Information-Motivation-Behavioral Skills model of HIV-preventive behavior (Fisher & Fisher, 1992) and employed activities designed specifically for people with a SMI. Data were collected at pre-and post-intervention, and at a one-month followup. Results indicated that this brief intervention resulted in enhanced HIV-related knowledge, and trends toward enhanced skill at condom use negotiation and condom use self-efficacy. Overall, a modest decrease in risk behavior among participants was observed. Thus, this pilot investigation revealed that HIV-related risk of the SMI can be reduced through traditional behavioral skills and education methods. Future research employing control groups, more intensive interventions, and baseline screening for high risk is encouraged.The term seriously mentally ill (SMI) typically refers to a heterogeneous group of approximately 2.8 million individuals (Auerbach, Wypijewska, & Brodie, 1994) who are diagnosed with psychotic or affective disorders (e.g., schizophrenia, schizoaffective disorder, bipolar disorder), and who exhibit chronic psychiatric symptoms, requiring at least short-term hospitalizations. Contrary to the stereotypical image of the asexual psychiatric patient (Harvis & Trivelli, 1990), recent surveys indicate that many SMI are sexually active, engage in high risk sexual behaviors, and experience enhanced risk for sexually transmitted diseases, including the human immunodeficiency virus (HIV; cf. Kalichman, Carey, & Carey, in press). Despite these characteristics and risk, researchers have been slow to address sexual risks among the SMI.Several recent survey studies have examined sexual risk behavior among the SMI (e.g., Cournos et al., 1994; Carey, Carey, Weinhardt, & Gordon, in press; Kalichman, Kelly, Johnson, & Bulto 1995;Kelly et al., 1992;Knox, Boaz, Friedrich, & Dow, 1994). These studies, which have been conducted across an array of treatment settings (i.e., inpatient, outpatient, homeless shelters) and geographic locations (e.g., Milwaukee, New York City, Syracuse), document that the SMI engage in behaviors that facilitate the transmission of HIV. Risk behaviors include unprotected intercourse, multiple sexual partners, high-risk partners (e.g., injection drug users), anonymous sexual partners, and use of alcohol and other drugs before sex.In addition to these risk behavior studies, a number of HIV-seroprevalence studies have been conducted with SMI samples. Carey, Weinhardt, and Carey (1995) aggregated the results across published seroprevalence studies and found that 5% (i.e., 28 / 550) of SMI women and 10% (i.e., 82 / 832) of SMI...

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

HIV risk reduction for the seriously mentally ill: Pilot investigation and call for research

Weinhardt

Carey

1997

Journal of Behavior Therapy and Experimental Psychiatry

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“…That such a high percentage of patients who refused testing believed they were not at risk is of particular interest, as nearly half of patients with SMI have been shown to believe that they are at lower risk for contracting HIV than they are objectively found to be [14]. It is important to note, however, that refusal data was not collected for all patients due to staffing shortages.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, several studies have identified substance abuse as the primary HIV risk factor in the mentally ill [12,13]. These patients have dramatically higher rates of substance abuse and injection drug use, frequently associated with sex while intoxicated and with partners who inject drugs [11,14].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to being a high-risk population, many patients with a SMI have significant deficiencies in their knowledge of HIV, while even those who have adequate knowledge are often unable to accurately identify their own level of risk [14][15][16][17]. This underscores the necessity of routine HIV screening over targeted, risk-based testing.…”

Section: Introductionmentioning

confidence: 99%

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