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Am J Psychiatry 1995; 152:583-587
Copyright © 1995 by American Psychiatric Association
Sexual behavior of homeless mentally ill men at risk for HIV
E Susser, E Valencia, M Miller, WY Tsai, H Meyer-Bahlburg and S Conover
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, NY 10032.
OBJECTIVE: The authors investigated sexual behaviors related to HIV
transmission among homeless mentally ill men in a New York City shelter. A
previous study of a similar population found HIV prevalence to be 19%.
METHODS: In standardized interviews with 122 men, data on sexual behaviors
for the previous 6 months were collected. The frequency and nature of
sexual episodes that may facilitate HIV transmission were examined. In
addition, sexual risk behaviors among broadly defined diagnostic groups
were compared. RESULTS: Of the 122 men, 65 (53%) had sex, 56 with women and
20 with men (11 who had sex with both women and men are counted in each
group). The sexually active men, in most cases, had only occasional sex
(once per month or less). The majority of sexually active men--29 (52%) of
those who had sex with women and 12 (60%) of those who had sex with
men--had sex without a condom and with nonmonogamous partners. Comorbid
cocaine abuse or dependence was significantly associated with high-risk
sexual behaviors. CONCLUSIONS: The majority of these men had sex
occasionally or not at all. Nonetheless, because many of them had
unprotected sex with nonmonogamous partners, the few sexual episodes may
have carried an appreciable risk of HIV transmission. Moreover, men with a
comorbid cocaine dependence may represent a group with an especially high
risk for sexual HIV transmission. The authors propose that in this
population, preventive interventions could modify the nature, if not the
frequency, of sexual episodes.
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