HIV risk behaviors remain a public health concern among people living with HIV (PLWH), particularly those facing mental health or substance use challenges. This study examined whether psychiatric severity predicts HIV risk behaviors and whether this relationship differs by sex. Understanding how psychiatric and demographic factors contribute to risk behaviors may inform more effective prevention strategies. A secondary data analysis was conducted using baseline data from the NIH-funded ART Adherence and Secondary Prevention of HIV study (R01-HD075630), which included 101 HIV-positive adults prescribed antiretroviral therapy. HIV risk was measured using the HIV Risk Behavior Scale (HRBS), with hierarchical linear regression models testing associations between psychiatric severity, sex, age, sexual orientation, and substance use diagnoses. Psychiatric severity was not a significant predictor of total HIV risk. However, sex and age significantly predicted HIV risk behaviors across all models, with males and older participants reporting higher scores. Cocaine dependence was also associated with increased HIV risk. These findings suggest that while psychiatric severity may not be a direct predictor, demographic and substance-related factors play a key role in HIV risk and should be prioritized in targeted interventions.
