Diagnostic and Other Correlates of HIV Risk Behaviors in a Probability Sample of Homeless Adults

OBJECTIVES: This study assessed the relationship between psychiatric disorders, including substance abuse and dependence, and risk behaviors for contracting HIV. METHODS: A probability sample of 218 homeless men and women were recruited from food programs and shelters assisting homeless individuals in an urban metropolitan community. Mood disorders, schizophrenia, and substance abuse and dependence diagnoses were assessed with the Diagnostic Interview Schedule (version 3A). Level of sexual activity and HIV risk behaviors (such as history of sexually transmitted diseases, ratio of protected sex, trading sex for money or drugs, sex with a prostitute, and sex under the influence of alcohol or drugs) also were measured. RESULTS: Substance abuse and dependence and the length of the homelessness episode at baseline were associated with the highest risk of engaging in HIV risk behaviors. However, there was no relationship between mood disorders, schizophrenia, and HIV risk behaviors. CONCLUSIONS: This study provides evidence that individuals who are homeless for extended periods and have a diagnosis of substance abuse or dependence may be especially vulnerable to engaging in risky sexual behaviors and contracting HIV. The findings highlight the importance of tailoring treatment programs to the specific needs of homeless individuals. (Authors)

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Psychiatric Services