HIV seroprevalence among people with severe mental illness in the United States: a critical review.

The authors reviewed all studies in the peer-reviewed literature reporting HIV seroprevalence among people with severe mental illness in the United States, which varied from 4.0% to 22.9%. Findings across samples suggest that seroprevalence varies with geographic concentration of HIV and presence of comorbid psychoactive substance use disorders, but is consistently high. Unsafe sex, drug injection, and noninjected drug use were associated with infection, and in most studies women were as likely to be infected as men. Seroprevalence also varied with age and ethnicity, but not psychiatric diagnosis. The authors review questions and methodological issues important to future studies.