Negotiating Risk: Knowledge and Use of HIV Prevention by Persons With Serious Mental Illness Living in Supportive Housing

Yale University, New Haven, Connecticut, USA.
American Journal of Community Psychology (Impact Factor: 1.74). 01/2006; 36(3-4):357-72. DOI: 10.1007/s10464-005-8631-1
Source: PubMed


As a population, persons with serious mental illness (SMI) have an elevated risk for HIV infection. However, relatively little is known about how the risk of HIV has affected their lives, how persons with SMI evaluate their HIV risk, and what preventive measures they undertake. Furthermore, relatively little is known about community-based HIV prevention for persons with SMI as most interventions have been restricted to clinical settings. This report presents findings on the HIV-related experiences of persons with SMI living in supportive housing programs, one possible setting for implementing community-based HIV prevention with this population. The qualitative investigation interviewed 41 men and women living in five supportive housing programs. In-depth, qualitative interviews elicited discussion of research participants' (a) experiences with HIV, (b) knowledge about HIV and HIV prevention, (c) assessments of their own risk, (d) descriptions of how they apply their prevention knowledge, and (e) reports of barriers for HIV prevention. Research participants describe social networks that have substantial contact with persons affected by HIV. However, contrary to some expectations of persons with SMI, research participants report using HIV prevention knowledge in negotiating their risk of contracting HIV. The implications of these findings are discussed in terms of their relevance for implementing community-based HIV prevention for persons with SMI.

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Available from: Christina S Meade
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    • "Risk for HIV infection among people with SMI has been associated with psychiatric symptom profile (McKinnon et al. 2001; Meade 2006) and cognitive impairment (McKinnon et al. 2002; Meade and Sikkema 2005); co-morbid substance use (McKinnon et al. 2001; Meade 2006; Meade and Sikkema 2007; Parry et al. 2007; Rosenberg et al. 2001b); history of childhood physical and sexual abuse (Devieux et al. 2007; Meade et al. 2009; Meade and Sikkema 2007); history of infection with a sexually transmitted disease (Vanable et al. 2006); relationship status (Meade 2006); type of treatment setting (Wright and Gayman 2005); inadequate assessment of personal risk (Kloos et al. 2005); multiple sexual partners, unprotected sex, and transactional sex (McKinnon et al. 2002; Meade and Sikkema 2005) and interactions among these factors. Questions remain regarding the epidemiology of HIV infection among people with SMI who live outside the epicenters of the epidemic; prevalence differences among diagnostic subgroups; as well as the intersecting social networks of people with SMI, injection drug users, and other high prevalence groups (Walkup et al. 2008). "
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