Negotiating Risk: Knowledge and Use of HIV Prevention by Persons With Serious Mental Illness Living in Supportive Housing

Abstract

As a population, persons with serious mental illness (SMI) have an elevated risk for HIV infection. However, relatively little is known about how the risk of HIV has affected their lives, how persons with SMI evaluate their HIV risk, and what preventive measures they undertake. Furthermore, relatively little is known about community-based HIV prevention for persons with SMI as most interventions have been restricted to clinical settings. This report presents findings on the HIV-related experiences of persons with SMI living in supportive housing programs, one possible setting for implementing community-based HIV prevention with this population. The qualitative investigation interviewed 41 men and women living in five supportive housing programs. In-depth, qualitative interviews elicited discussion of research participants' (a) experiences with HIV, (b) knowledge about HIV and HIV prevention, (c) assessments of their own risk, (d) descriptions of how they apply their prevention knowledge, and (e) reports of barriers for HIV prevention. Research participants describe social networks that have substantial contact with persons affected by HIV. However, contrary to some expectations of persons with SMI, research participants report using HIV prevention knowledge in negotiating their risk of contracting HIV. The implications of these findings are discussed in terms of their relevance for implementing community-based HIV prevention for persons with SMI.

“What It Means To Be a Woman:” Ambivalent Sexism in Female College Students’ Experiences and Attitudes

“…Analytic techniques for the qualitative data included modified grounded theory (Miles and Huberman 1994;Kloos et al 2005). Essays were coded for themes that were relevant to ambivalent sexism theory, as well as whether the statement expressed agreement or disagreement with ambivalent sexism ideology.…”

“…After coding was complete, data audits were conducted by essay (within-case) and by coding category (between-case) (Kloos et al 2005;Miles and Huberman 1994). These audits resulted in the removal of some codes for Agreement with Complementary Gender Differentiation and Disagreement with Protective Paternalism because the coding team decided that the meaning of the surrounding text of some coded material was not explicit enough to retain the code.…”

Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review

“…Some found that people with SMI attribute the risk to people with homosexual preferences (Ngwena, 2011;Stevenson & Eilers, 1992) and usually say that people with HIV have a sickly appearance due to the fact that they ignore the conceptual difference between HIV and AIDS (Carey et al, 1997;Kloos et al, 2005;Strauss et al, 2006;Gordon, Carey, Carey, Maisto & Weinhardt, 1999).…”

“…These factors are deemed to be implied, are beyond a person's control and reduce his/her ability to avoid risk, such as social exclusion for human rights' violation Stevenson & Eilers, 1992;Taylor, 2007), poor quality and coverage of health services, and social stigma of illness, among others (Collins, 2001;Kloos et al, 2005).…”

Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness

“…The inclusion of adults with SMI in the adaptation or development process of an HIV prevention intervention has not been described in the literature until quite recently (Gordon, Carey, Carey, Maisto, & Weinhardt, 1999;Kloos, Gross, Meese, Meade, Doughty, & Sikkema, 2005). None of these studies incorporated the experiences of both patients and staff.…”