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Kloos et al. (2005) interviewed 41 men and women with severe mental illness (SMI) living in five supportive housing programs regarding their HIV-related knowledge and experiences. Importantly, these investigators found that "a substantial number of persons in these settings already engage in their own HIV prevention informed by public health messages. ... [Kloos and colleagues] suggest, however, that specialized HIV prevention integrated into mental health care is needed which goes beyond education about risks and prevention methods and allows for processing of emotional material and addressing motivational challenges to implementing HIV prevention within the context of supportive settings" (p. 371).
More specifically, Kloos and colleagues recognize that
[a] range of approaches to intervention may be needed based upon persons' prior experiences with HIV. ... Persons who "witnessed" suffering from AIDS acquired vibrant images about the effects of the disease. Interventions with these individuals may need to allow for processing of these experiences to allow for effective learning of health promotion skills. In contrast, few persons who experienced the less intimate "confronting their own HIV risk" as the result of personal interaction connected their stories to health promotion practices, as did those who "witnessed" AIDS suffering. Interventions for persons with these experiences may need to accommodate both fear-based motivations for learning about HIV prevention skills and health promotion interests. Finally, a last category of participants was less emotionally engaged about HIV in their accounts. ... [and] interventions for them will likely need to take into account that some intervention practices, particularly ones designed for those bearing witness to AIDS, may overwhelm persons with SMI who are less emotionally engaged with the subject of HIV and HIV risk. ...
One promising ... prevention strategy may be to embed integrated interventions into "host" settings that can help facilitate learning of skills, assist emotional processing, and provide interpersonal support for implementation of prevention knowledge. Supportive housing for people with SMI may offer such an opportunity to structure a prolonged intervention with supportive resources to work through prevention barriers. These settings appear to be in a position to capitalize on individuals' desire to make changes in their lives (e.g., sobriety, recovery from SMI, work, independent living) ... [and t]he support of fellow residents and staff is a promising resource to help residents consistently use prevention methods. (p. 370)
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Spring 2006 Newsletter / Volume 7, Issue 3 
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