Self-Reported HIV- Related Risk Behaviors in Acute Psychiatric Inpatients: A Pilot Study

Sacks, Michael H.; Perry, Samuel W.; Graver, Ruth L.; Shindledecker, Richard; Hall, Stephen B.

doi:10.1176/ps.41.11.1253

Cited by 33 publications

(27 citation statements)

References 4 publications

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“…33 Increased risk may also be attributable to little fear of HIV and a low perception of personal risk. 34,35 Cognitive impairments associated with SMI may negatively affect individuals_ ability to make decisions in their own best interest or appropriately weigh the risks versus benefits of specific sexual behaviors. 36 The prevalence of homelessness among SMI persons may be as high as 45%, 37 while the prevalence of HIV infection among SMI homeless persons has been found to be as high as 19%.…”

mentioning

confidence: 99%

Spirituality, Coping, and HIV Risk and Prevention in a Sample of Severely Mentally Ill Puerto Rican Women

Loue

Sajatovic

2006

J Urban Health

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mentioning

confidence: 99%

Spirituality, Coping, and HIV Risk and Prevention in a Sample of Severely Mentally Ill Puerto Rican Women

Loue

Sajatovic

2006

J Urban Health

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“…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). When individuals do not recognize the connection between their behavior and risk for infection with HIV, or other behavior-health associations, there may be few other incentives for modifying the risk-conferring behavior (Janz & Becker, 1984).…”

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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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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“…A recent study from the United States found that people with affective disorders were 4.07 times more at risk of contracting HIV in comparison with people diagnosed with schizophrenia (Wu, Rothbard & Blank, 2011). On the other hand, studies made in the United States and Italy found that people with bipolar disorders were more vulnerable to being infected with HIV than those with other disorders for five reasons: 1. greater frequency of sexual behavior than schizophrenic patients (Raja & Azzoni, 2003) and those suffering from depression (Sacks, Dermatis, Burton, Hull & Perry, 1994); 2. among women, more STI during their lifetime than unipolar depressive patients (Meade & Sikkema, 2007); 3. greater seropositivity (Henning et al, 2012;Volavka, Convit, Czobor, Douyon, O'Donnell & Ventura, 1991); 4. among adults of both genders, greater susceptibility to become infected by hepatitis C than people with depression or psychotic disorders (Carey et al, 2004); and 5. a greater number of risk factors associated with HIV risk than people with other kinds of SMI (Meade, Bevilacqua & Key, 2012;Sacks, Silberstein, Weiler & Perry, 1990).…”

Section: Risky Behavior By Type Of Severe Mental Illnessmentioning

confidence: 99%

“…Two studies from the United States have described a greater frequency of risky behavior by men with SMI than by women with SMI even though there is a more frequent use of preventive strategies by men (Knox et al, 1994;Sacks, Perry, Graver, Shindledecker & Hall, 1990). In Uganda's population (18-49 years), females had higher risk of HIV infection than males (OR 2.10) (Lundberg, Nakasujja, Musisi, Thorson, Cantor-Graae & Allebeck, 2013).…”

Section: Gender Inequality and Vulnerabilitymentioning

confidence: 99%

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

Galarza‐Tejada

Caballero-Hoyos

Lira

2017

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Background. People with a severe mental illness (SMI) are a highly vulnerable group for the transmission risk of the human immunodeficiency virus (HIV). They have a higher seroprevalence compared with the general population and their life expectancy is shorter than those of people without the disease. This narrative review describes individual factors or those inherent to a person's characteristics and the sociocultural factors conditioning sexual behaviour and prevention norms. Objective. The purpose of this narrative review is to describe individual and sociocultural factors associated with the risk of HIV in people with a severe mental illness. Method. 82 empirical studies published between 1981 and 2015, addressing HIV transmission risk factors and sociocultural dimensions related to vulnerability were selected. Four indexes were used for this purpose: ISI Web of Knowledge, Redalyc, SciELO, and PUBMED; and four multidisciplinary electronic databases: Ebscohost Web, ProQuest, Sage Publications and ScienceDirect. Results. The analysis based on coding and systematic categorization shows that people with SMI are more vulnerable to risk than the general population, with differentials based on the severity of the disease symptomatology and economic and sociocultural characteristics associated with HIV-related risk practices. Discussion and conclusion. The need to design longitudinal studies with mixed methodology is proposed to attain a deeper understanding of the interaction of factors associated and processes conditioning risk. In this population group, structural preventive programs that take into account social and gender inequality must be implemented.

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Self-Reported HIV- Related Risk Behaviors in Acute Psychiatric Inpatients: A Pilot Study

Cited by 33 publications

References 4 publications

Spirituality, Coping, and HIV Risk and Prevention in a Sample of Severely Mentally Ill Puerto Rican Women

Spirituality, Coping, and HIV Risk and Prevention in a Sample of Severely Mentally Ill Puerto Rican Women

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

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

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