Patients are sexually active. Patients have knowledge of HIV and risk behaviors. Patients use condoms infrequently. Patients are subject to SMI stigma, which may increase their HIV risk. |
There are no explicit policies regarding sexual behavior. Mental Health Care Providers (MHCPs) address HIV prevention idiosyncratically; there is need for training and for systematic HIV prevention interventions. Patients’ sexuality tends to be viewed by MHCPs as connected to psychiatric instability and not as a normal human behavior; communication with MHCPs about safer sex/sexuality must be addressed. |
Patients are comfortable talking about sex and want to learn HIV prevention skills. Patients want to learn about HIV testing. Stigma about homosexuality and about people living with HIV/AIDS must be addressed. Gender roles must be addressed. Patients can and want to function as prevention agents; the intervention should include the locally valued prevention message of “social responsibility” and communication with other patients and staff. Patients feel excluded from romantic relationships; families are key in promoting safer and healthier sexuality and in intervention participation; how to communicate with relatives about intervention content and participation must be included. Religious and other beliefs (e.g., “magical thinking”) regarding HIV risk must be addressed. Sexual violence and “desperation sex” (i.e., sex trading and sex work) must be addressed. |
Patients requested a closed-group intervention (no new members after group begins), with anywhere from 6–10 weekly sessions, including men and women together. Patients expected the intervention would use interactive approaches (including movement and music) and exercises that increase knowledge, motivation and prevention skills acquisition. MHCPs and patients chose the content of the control intervention: common chronic medical conditions that are comorbid with psychiatric illness. |
