Effects of AIDS counseling and risk reduction training on the chronic mentally ill.

The chronic mentally ill are a high-risk group for HIV infection. In this study 27 chronic mentally ill psychiatric outpatients were randomly assigned to either an AIDS education and risk reduction training group or to a no-treatment control group. Training was conducted during four 2-hour group meetings that were scheduled over 4 days. Treated patients were instructed on modes of HIV transmission and high-risk groups and practices. They were instructed on the importance of using condoms and also taught problem-solving and refusal skills to cope with high-risk sexual and drug and alcohol situations. Assessments were made immediately before and after training as well as during a 2-week follow-up. Participants who received training showed significant improvement in their knowledge about AIDS, their confidence to deal with high-risk situations, and on behavioral measures of coping in high-risk situations. No such improvement was noted in the control group. There was also evidence of maintenance over the 2-week follow-up. Although the magnitude of change was small, the results of the study are encouraging considering the brevity of treatment, the high degree of risk and difficulty faced with this patient population, and the fact that even a small amount of behavior change can make the difference between encountering and avoiding the HIV virus.