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-delated 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:
1. (a) better tailor interventions to risk situations encountered by the mentally ill;
2. (b) develop gender-tailored interventions;
3. (c) examine and implement HIV prevention programs so they help persons sustain behavior change;
4. (d) explore one-on-one counseling and community-level intervention methods;
5. (e) develop risk reduction interventions for already-seropositive individuals.
Implications for service provision are discussed
