Community Mental Health Journal

, Volume 43, Issue 2, pp 153-169

First online:

Psychiatric and Psychosocial Correlates of Sexual Risk Behavior among Adults with Severe Mental Illness

  • Christina S. MeadeAffiliated withHarvard Medical School, McLean Hospital Email author 
  • , Kathleen J. SikkemaAffiliated withDepartment of Epidemiology and Public Health, Yale University

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Persons with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study examined multivariate correlates of sexual risk among 152 adults with SMI receiving outpatient psychiatric treatment. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. The majority was sexually active (65%), and many reported unprotected intercourse (73%), multiple partners (45%), and sex trading (21%) in the past year. Logistic regression models found that sexual behaviors were differentially associated with non-psychotic disorder, psychiatric symptoms, substance abuse, childhood sexual abuse, romantic partnership, and social support (all ps < .05). Findings underscore the need for targeted HIV prevention interventions that address psychiatric and psychosocial risk factors.


HIV/AIDS sexual risk behavior severe mental illness