title: Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness.
abstract: We examined the prevalence and correlates of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) risk behaviors in a large sample of severely mentally ill (SMI) patients. Risk levels were correlated with demographic factors, diagnosis, symptom severity, trauma history, post-traumatic stress disorder (PTSD), substance use disorder (SUD), and sexual orientation. SMI clients from urban and rural settings (N = 275) were assessed regarding HIV/AIDS risk behaviors, and hypothesized risk factors. Patients exhibited substantial levels of risky behavior, particularly sexual risk. Correlates of increased risk included SUD, trauma, male homosexual orientation, younger age, and symptom severity. Structural equation modeling identified SUD and sexual orientation as the primary determinants of both drug and sexual risk behavior. We conclude that specific illness related variables appear to have less impact on risk behavior among people with SMI than previously hypothesized. Substance abuse prevention and treatment may be the most effective means of reducing HIV risk in this population.
authors.affiliation: New Hampshire-Dartmouth Psychiatric Research Center, Lebanon, NH 03766, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Rosenberg
authors.forename: S L
authors.initials: SL
authors.lastname: Trumbetta
authors.forename: K T
authors.initials: KT
authors.lastname: Mueser
authors.forename: L A
authors.initials: LA
authors.lastname: Goodman
authors.forename: F C
authors.initials: FC
authors.lastname: Osher
authors.forename: R M
authors.initials: RM
authors.lastname: Vidaver
authors.forename: D S
authors.initials: DS
authors.lastname: Metzger
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D012309:Risk-Taking; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology