The impact of psychiatric symptoms on condom self-efficacy among people with serious mental illness.

OBJECTIVE

To determine how psychiatric symptoms affect the self-efficacy of people with serious mental illness to protect themselves and their partners from HIV and other sexually transmitted infections (STIs) by using condoms.

METHOD: As part of a National Institute of Mental Health-Funded study, people with serious mental illness (N = 467) were recruited in public psychiatric outpatient clinics in Rio de Janeiro, Brazil for an HIV prevention intervention. We examined the effects of psychiatric symptom severity on condom self-efficacy at baseline across 4 symptom clusters: affect, positive, negative, and activation.

RESULTS

Greater activation symptom severity (e.g., elated mood) was related to better condom self-efficacy, whereas greater negative symptom severity (e.g., blunted affect, emotional withdrawal) was related to worse condom self-efficacy.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Our findings suggest that people living with serious mental illness who exhibit more severe negative symptoms are less likely to perceive themselves as capable of using condoms, condom negotiation, and/or condom acquisition, whereas those with more severe activation symptoms are more likely to express confidence in their capabilities. Interventions to prevent HIV and other STIs among people living with serious mental illness should take into account the effects of these symptom clusters on condom skills acquisition and perceptions of self-efficacy in carrying out needed protective behaviors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).