Abstract
Adults with mental illness are at elevated risk of contracting HIV. To identify especially vulnerable subgroups of this population and to develop effective HIV-prevention interventions, a better understanding of the linkages between psychopathology and HIV risk is needed. The current study was designed to determine if factor-analytically derived indices of psychiatric severity based on MCMI-III scale scores were linked with HIV risk behavior and putative cognitive-behavioral mediators of risk behavior, and to determine if cognitive-behavioral factors mediated the expected relationships between psychiatric severity and HIV risk behavior. The sample included 280 adult men and women with mental illness. Greater general psychiatric severity was hypothesized to be linked with elevated proportions of unprotected sex and with deficits in HIV knowledge, intention to practice safer sex, and condom use skills. It was also hypothesized that these presumed cognitive-behavioral factors would mediate the expected relationship between general psychiatric severity and unprotected sex. Additionally, it was hypothesized that greater externalizing psychopathology would be linked with elevated levels of unprotected sex and that intention to practice safer sex would mediate this expected relationship. Linear regression analysis revealed that general psychiatric severity was associated with deficits in HIV knowledge. No other hypotheses were supported. Study limitations and suggestions for further research are discussed.