AIDS and Behavior

, Volume 5, Issue 3, pp 233–240 | Cite as

A Lifetime Alcohol or Other Drug Use Disorder and Specific Psychiatric Symptoms Predict Sexual Risk for HIV Infection Among People With Severe Mental Illness

  • Karen McKinnon
  • Francine Cournos
  • Richard Herman


To clarify the relative contributions of psychiatric and alcohol or other drug (AOD) use disorders on sexual risk for HIV infection among people with severe mental illness, we interviewed 195 psychiatric patients. In the prior 6 months the 100 (51%) sexually active patients had a mean of 3.9 sex partners and 27.5 sex episodes; 49% had known high-risk sex partners; 34% used AOD during sex; 28% traded sex; and 59% never used condoms. The likelihood of being sexually active decreased with age and cognitive symptoms, increased with excited symptoms, and was more than twice as high for African-American patients as others. The likelihood of trading sex increased with cognitive symptoms. The likelihood of having a sexually transmitted disease history (reported by 32% of all patients) increased with depressed/anxious symptoms, a lifetime AOD use diagnosis (obtained for 57% of patients), and was more than twice as high for African-American patients as others. HIV prevention interventions that address specific psychiatric conditions and developmental and cultural issues of psychiatric patients should be developed and tested.

HIV risk psychiatric symptoms severe mental illness alcohol or other drug use disorder sexual behavior 


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Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Karen McKinnon
    • 1
    • 2
    • 3
    • 4
  • Francine Cournos
    • 1
    • 2
    • 3
    • 4
  • Richard Herman
    • 1
    • 2
    • 3
    • 4
  1. 1.Columbia University HIV Mental Health Training Project
  2. 2.Department of PsychiatryColumbia University College of Physicians and SurgeonsNew York
  3. 3.New York State Psychiatric Institute
  4. 4.Washington Heights Community Service

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