Use of a brief behavioral skills intervention to prevent HIV infection among chronic mentally ill adults.

OBJECTIVE: Research shows that many chronic psychiatric patients are at risk for infection by the human immunodeficiency virus (HIV). This study investigated the effects of a behavioral skills training program designed to prevent HIV infection among chronic mentally ill adults living in an inner-city area. METHODS: Twenty-seven men and 25 women were randomly assigned either to a four-session AIDS prevention program emphasizing risk education, sexual assertiveness, condom use, risk-related behavioral self-management, and problem-solving skills or to a waiting-list group, who later received the same intervention. RESULTS: Compared with the waiting-list control group, participants in the prevention program demonstrated significant gains in AIDS-related knowledge and intentions to change risk behaviors. The prevention program also significantly reduced rates of unprotected sexual intercourse and increased the use of condoms over a one-month follow-up period. A subset of participants who provided two-month follow-up data maintained some behavior changes. CONCLUSIONS: A relatively brief, skills-focused AIDS prevention program for chronic psychiatric patients produced reductions in HIV risk behaviors. Such HIV risk reduction intervention programs may be of use in inpatient, outpatient, and community-based settings.

Buspirone in obsessional compulsive disorder. A prospective case study.

A longitudinal case study of a man who is suffering from obsessional compulsive disorder, who failed to respond to all possible treatments, including psychosurgery. We present his good response to the recommended dose of the anxiolytic Buspirone and its effect on the severity of his obsessive compulsive symptoms.

Factors associated with risk for HIV infection among chronic mentally ill adults.

OBJECTIVE: Chronic mentally ill adults have been found to be at risk for HIV infection. The authors investigated the prevalence of HIV risk behaviors among psychiatric outpatients. Correlates of HIV risk factors and characteristics of patient relationships in which risk occurred were investigated. METHOD: Structured interviews were conducted with 95 chronic mentally ill adults from urban community support service programs. The interviews focused on sexual and substance use behavior, history of HIV risk behaviors, and relationship characteristics related to risk. RESULTS: The study showed that 27% of all patients had had two or more sex partners in the previous year and 18% had received money or drugs for sex. High rates of illicit drug use were also found, with frequent use of drugs or alcohol in association with sexual activity. Multiple regression analyses showed that use of illicit drugs, meeting sex partners in psychiatric clinics, and meeting partners in bars accounted for a substantial proportion of the variance in HIV risk behavior. CONCLUSIONS: These results suggest an urgent need for HIV prevention programs targeted at urban chronic mentally ill adults. Risk-producing characteristics of patient relationships and social networks should be addressed in the development of prevention interventions.