Florida International University, Biscayne Bay Campus, 3000 NE 151 St, AC1 #260, Miami, FL 33191, USA.
AIDS Behav. 2012 Jul;16(5):1192-202. doi: 10.1007/s10461-011-0104-y.
Among severely mentally ill (SMI) substance abusers, HIV rates are elevated and HIV risk reduction interventions have been shown to be less effective. An enhanced cognitive behavioral HIV risk reduction intervention (E-CB) for SMI was compared to a health promotion condition (HPC) in 222 psychiatric outpatients at 6 months postintervention. Compared to females, males in the E-CB improved on intention to practice safer sex and in condom use skills and in unprotected vaginal sex, but did not differ in HIV knowledge, perceived susceptibility, anxiety, condom attitudes, safer sex self-efficacy, unprotected vaginal sex acts, or sex partners. Across intervention groups, there were improvements in all areas except self-efficacy and number of partners. Risk reduction among SMI may be facilitated by increasing awareness of health related behaviors and HIV-targeted content. However, meaningful changes in critical risk reduction skills and intentions may require a more focused intervention and may vary by gender.
在严重的精神疾病（SMI）物质滥用者中，HIV 感染率较高，HIV 风险降低干预措施的效果较差。一项针对 SMI 的强化认知行为 HIV 风险降低干预（E-CB）与健康促进条件（HPC）在 222 名精神科门诊患者中进行了比较，在干预后 6 个月进行了比较。与女性相比，E-CB 组的男性在实施安全性行为的意愿和使用避孕套的技能以及无保护的阴道性交方面有所改善，但在 HIV 知识、感知易感性、焦虑、避孕套态度、安全性行为自我效能感、无保护的阴道性交行为或性伴侣方面没有差异。在干预组中，除了自我效能感和性伴侣数量外，所有领域都有所改善。通过提高对与健康相关的行为和 HIV 针对性内容的认识，可能有助于减少 SMI 的风险。然而，在关键的风险降低技能和意图方面的有意义的变化可能需要更有针对性的干预，并且可能因性别而异。
