Session number: 1092
Abstract title: Limited Knowledge of HIV Risks Among Veterans With Severe Mental Illnesses
Author(s):
JL Strauss - Durham VAMC
HB Bosworth - Durham VAMC
KNS Stechuchak - Durham VAMC
KL Dominick - Durham VAMC
KG Meador - Durham VAMC
MI Butterfield - Durham VAMC
Objectives: Persons with severe mental illness (SMI) have high rates of HIV and associated risks. Standard HIV awareness and prevention efforts may not effectively reach this population. The current study evaluated knowledge of HIV risks in veterans with SMI.
Methods: Participants with primary diagnoses of schizophrenia, schizoaffective, bipolar disorder or PTSD were recruited from the Durham VAMC psychiatric inpatient unit between 1998-2000. The analyzed sample (N = 353) was restricted to male veterans who tested negative for HIV. Participants were 20-80 years of age; over 50% were African American. Participants completed the AIDS Risk Inventory, which probes knowledge and risks of HIV transmission. Analyses focused on interview items specific to knowledge and beliefs about HIV transmission and self-reported risk behaviors.
Results: Forty-one percent of participants answered at least one knowledge item incorrectly. Those with schizophrenia were more likely to have incorrect responses than those with PTSD. In adjusted analyses, demographic factors that predicted incorrect response included younger age, minority status, and less than high school education. Beliefs that predicted incorrect response included self-ratings of “no/very little chance of acquiring HIV” and a “large” chance of acquiring HIV compared to an IV drug user who shares needles. Behavioral predictors of incorrect response included sexual abstinence vs. those with multiple sex partners, and no reported history of intranasal drug use.
Conclusions: These findings indicate that many veterans with SMI have a poor understanding of HIV risks, particularly those who are younger, less educated, of minority status and/or have schizophrenia. A subset of this SMI sample reported elevated rates of risk behaviors despite more knowledge of HIV risks.
Impact statement: Future VA HIV prevention/education efforts must include persons with SMI. Enhancement of HIV prevention efforts to help high risk veterans with SMI reduce HIV risk behaviors also merits attention.