title: HIV risk reduction interventions for persons with severe mental illness.
abstract: Recent seroprevalence studies have shown alarming rates of HIV infection among severely mentally ill men and women in large urban areas, and HIV behavioral epidemiology research indicates that a substantial proportion of seriously mentally ill adults engage in activities that increase their vulnerability to HIV/AIDS. In this paper, the research literature on HIV prevention interventions is reviewed including reports that have described HIV prevention programs, studies that have used uncontrolled pre- and postintervention methods to evaluate risk reduction interventions, and those that have used rigorous randomized designs and examined risk behavior change. Collectively, these studies show that intensive, small-group interventions that target a variety of risk-related dimensions-including knowledge, attitudes, and motivations, and behavioral and cognitive skills-can produce at least short-term reductions in high-risk sexual behavior among the severely mentally ill. A number of gaps in the research literature are identified including the need to: (a) better tailor interventions to risk situations encountered by the mentally ill; (b) develop gender-tailored interventions; (c) examine and implement HIV prevention programs so they help persons sustain behavior change; (d) explore one-on-one counseling and community-level intervention methods; and (e) develop risk reduction interventions for already-seropositive individuals. Implications for service provision are discussed.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee 53202, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Kelly
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D000328:Adult; D001521:Behavior Therapy; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005544:Forecasting; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D015528:HIV Seroprevalence / Q000639:trends; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012306:Risk; D014481:United States / Q000453:epidemiology