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HIV/AIDS risk among chronic mentally ill adults: patterns, predictors, and gender differences in risk.
Stevenson LY; Otto-Salaj LL; Heckman TG; Kelly JA; Center for AIDS
January 30, 1997
Int Conf AIDS. 1996 Jul 7-12;11(1):176 (abstract no. Mo.D.1713). Unique

Objectives: To characterize HIV risk behavior patterns (including gender differences) among chronic mentally ill adults and to identify psychological and situational factors associated with high levels of sexual risk behavior. Methods: One hundred twenty-five chronic mentally ill adults receiving services in urban community-based mental health programs who were at risk for HIV through sexual or drug use history were assessed on HIV risk behavior knowledge, sexual and drug use behavior, risk situations encountered, self-esteem, substance use, and perceived risk for HIV infection. A forward stepwise logistic regression analysis was conducted to define predictors of levels of risk. High-risk participants were defined as those who reported any unprotected vaginal or anal sex in the past three months and low-risk participants as those who reported no unprotected vaginal or anal sex in the three month period. Results: Significant univariate predictors of HIV risk included: current relationship status with respondents having regular sexual partners being less likely to use condoms even when the regular partner had a concurrent outside relationship and the participant had been treated for a sexually transmitted disease (p is less than .0001); weaker risk reduction behavioral intentions (p is less than .001); higher perceived risk for HIV (p is less than .0005); gender, with women having more frequent unprotected intercourse, more coercive sex, and more often engaging in survival sex (p is less than .05); and substance use prior to sex (p is less than .10). Conclusions: HIV prevention efforts are needed to correct misconceptions, address substance use and HIV risk, strengthen risk reduction behavioral intentions, self-efficacy, and skills among the chronic mentally ill in the context of relationships as well as casual partnerships.

*Acquired Immunodeficiency Syndrome/TRANSMISSION *HIV Infections/TRANSMISSION *Knowledge, Attitudes, Practice *Mental Disorders/PSYCHOLOGY *Sex Behavior