HIV Prevention Among Men with Severe Mental Illness: Preliminary Results from a Randomized Clinical Trial

Daniel B. Herman
New York State Psychiatric Institute
Columbia University
100 Haven Ave., #16D
New York, NY  10032
212-740-5904
dbh14@columbia.edu
Purpose
The primary objective of this study is to establish the efficacy of a cognitive-behavioral  HIV sexual risk reduction intervention among men with severe mental illness (SMI) through a randomized controlled trial.

Methods
The sample will comprise 200 sexually active men drawn from outpatient psychiatric clinics in high HIV-prevalence urban communities in and around New York City.  All 200 men recruited for this trial will receive an initial HIV education session with instruction on condom use before being randomized to the experimental or control conditions.  The men will then be randomly assigned to either the experimental intervention, which comprises 10 educational group sessions followed later by five maintenance sessions, or to the control money management intervention which also comprises 10 educational group sessions followed later by five maintenance sessions.

The participants will be followed for 12 months after the intervention. The primary outcome will be sexual risk behavior during the follow-up period, which will be assessed using instruments of demonstrated reliability.

Results
As of April, 2001, approximately 120 men have been enrolled in the study and have completed either the experimental or control interventions.  By January, 2002, it is anticipated that all 200 men will have completed the intervention.  At that time, we will describe the intervention, report descriptive data on baseline sexual risk, and discuss problems and issues encountered in the design and implementation of the study.  If available, preliminary outcome data may also be presented.

Implications for Social Work Practice
HIV has emerged as a leading cause of morbidity and mortality among men and women with severe mental illness.  This intervention, if demonstrated to be effective, may be a valuable tool for use by social workers and others working with severely mentally ill persons who are at high risk of contracting sexually transmitted diseases including HIV.