This study will test an intervention to reduce sexual risk behaviors in a high risk impaired population: home-less men with mental illness. Two hundred participants will be recruited from a psychiatric program in a shelter for homeless men located in Nashville, Tennessee. The majority will be African Americans, have a chronic psychotic disorder, and a co- morbid substance use disorder. In a randomized clinical trial, will be assigned to an experimental cognitive-behavioral or a control intervention, and followed up over 18 months. The experimental intervention, Sex, Games, and Videotapes, SEXG (Susser et al., 1994) will be comprised of 6 sessions. The control intervention will be a one session HIV educational program. Sexual risk behavior will be the primary outcome. Experimental and control groups will be compared with respect to the mean scores on a sexual risk index. The maintenance of sexual risk behavior resulting the SEXG intervention and the control curriculum will be assessed at six week intervals for a period of 18 months.
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