HIV, Homelessness, and Serious Mental Illness: Implications for Policy and Practice

摘要

By December 1995, more than 513,000 cumulative cases of AIDS (Acquired Immune Deficiency Syndrome) had been diagnosed in the United States, and an estimated 750,000 Americans were infected with the human immunodeficiency virus (HIV) that is a cause of this fatal disease (Centers for Disease Control, 1996). The AIDS epidemic poses one of the greatest challenges ever faced by the modern health care system. Within psychiatric practice, it confronts providers with complex clinical challenges and difficult ethical dilemmas. Despite a burgeoning literature on the psychiatric and neuropsychiatric aspects of HIV infection, there is surprisingly little literature on the impact of the epidemic on people with serious mental illnesses. Little is known about the rates of infection and risk behaviors for HIV among this population. Even less is known about HIV prevalence and risk behaviors for people with mental illnesses who are homeless. Yet, what data does exist indicates that this population is at considerable risk for both contracting and transmitting this infection.