title: Triple jeopardy for HIV: substance using Severely Mentally Ill Adults.
abstract: Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.
authors.affiliation: Florida International University, College of Health and Urban Affairs, Stempel School of Public Health, Biscayne Bay Campus, 3000 NE 151st Street, ACI 260, Miami, FL 33181, USA.
authors.forename: Jessy G
authors.initials: JG
authors.lastname: Devieux
authors.forename: Robert
authors.initials: R
authors.lastname: Malow
authors.forename: Brenda G
authors.initials: BG
authors.lastname: Lerner
authors.forename: Janyce G
authors.initials: JG
authors.lastname: Dyer
authors.forename: Ligia
authors.initials: L
authors.lastname: Baptista
authors.forename: Barbara
authors.initials: B
authors.lastname: Lucenko
authors.forename: Seth
authors.initials: S
authors.lastname: Kalichman
mesh_terms: D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011581:Psychological Tests; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D016036:Seroepidemiologic Studies; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D018434:Sickness Impact Profile; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*