Journal of Health Care for the Poor and Underserved

This study examined injection drug use and HIV risk behaviors in a predominantly African American sample of homeless men with mental illness. Personal interviews focusing on injection drug use and sexual risk behaviors were completed with 240 homeless mentally ill men in two shelters in a southeastern city. Sixty-two (26%) of the 240 men injected drugs. Among the injection drug users (IDUs), most reported high-risk behaviors, including needle sharing (70%) and participation in shooting galleries (71%). Very few performed risk reduction activities (e.g., cleaning needles with bleach [19%] or using a needle exchange program [0%]). Within the preceding 6 months, most of the IDUs had had sex with women (51%) or men (8%) without a condom. This investigation reported a high lifetime occurrence of injection drug use in a sample of predominantly African American homeless men with mental illness. The IDUs reported intravenous drug use and sexual activities with great risk of HIV transmission and provided little evidence of risk-reduction efforts. These men are outside of most social service and health care systems but must be included in special programs to decrease the transmission of HIV.