HIV risk behavior among patients with co-occurring bipolar and substance use disorders: Associations with mania and drug abuse

Abstract

Background-Bipolar and substance use disorders frequently co-occur, and both are associated with impulsivity, impaired judgment, and risk-taking.Objectives-This study aimed to: (1) describe the rates of HIV sexual and drug risk behaviors among patients with co-occurring bipolar and substance use disorders, (2) test whether acute mania, psychiatric severity, and drug severity independently predict HIV risk, and (3) examine the relationship between specific substance dependencies and sexual risk behaviors.Method-Participants (N = 101) were assessed for psychiatric diagnoses, substance abuse, and HIV risk behavior using structured clinical interviews and self-report questionnaires.Results-The majority (75%) were sexually active in the past 6 months and reported high rates of sexual risk behaviors, including unprotected intercourse (69%), multiple partners (39%), sex with prostitutes (24%, men only), and sex trading (10%). In a multivariate linear regression model, recent manic episode, lower psychiatric severity, and greater drug severity were independent predictors of total HIV risk. Cocaine dependence was associated with increased risk of sex trading.Conclusions-Results underscore the importance of HIV prevention for this population.

Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review

“…A study about HIV transmission risk made in the United States with bipolar people found that less psychiatric severity, the presence of a recent manic episode and a greater frequency in the use of illegal drugs were significant predictor factors (Meade et al, 2008). Another study made with people with bipolar disorders and HIV+ (where 91 had an affective episode before being diagnosed with HIV) reported that the presence of more manic and depression symptoms was significantly associated with unsafe sexual intercourse.…”

“…They have also found a connection between use and a search for multiple sex partners (Coverdale et al, 1997), as well as occasional or unknown sex partners (Meade, Graff, Griffin & Weiss, 2008;Susser et al, 1995). A study made in the United States with adolescents undergoing psychiatric treatment where substance use was not the primary diagnosis revealed a close relation between cocaine and crack use with the presence of risky sexual behavior for HIV (Tolou-Shams, Ewing, Tarantino & Brown, 2010).…”

“…In the case of men, studies propose different risk factors associated with HIV transmission: a greater number of sexual partners and use of substances during sexual intercourse (Meade & Sikkema, 2007;Otto-Salaj et al, 1998), sex with partners who inject drugs (Susser et al, 1997) and sexual intercourse with occasional partners (Meade et al, 2008).…”

Correlates of substance use disorder in bipolar disorder: a systematic review and meta-analysis

“…Those with substance abuse (SA) or SUD also have greater overall severity, with increased manic symptoms and psychosis (Van Rossum et al, 2009), longer time spent in affective episodes (Gaudiano et al, 2008;Strakowski et al, 2007), impaired functional impairment (Goetz, Tohen, Reed, Lorenzo, & Vieta, 2007), lower quality of life (Singh, Mattoo, Sharan, & Basu, 2005) and more HIV risk behaviours (Meade, Graff, Griffin, & Weiss, 2008).…”

Significados sobre la prevención del riesgo de VIH en cibernautas con trastorno bipolar

“…7 Un estudio realizado en Estados Unidos en población con TAB encontró que el mayor uso de sustancias psicoactivas, la menor gravedad psiquiátrica y la presencia de un episodio maniaco reciente eran factores predictores significativos para el riesgo de transmisión de VIH. 8 Por su parte, un estudio realizado en adolescentes nigerianos con bipolaridad encontró que la comorbilidad, principalmente con trastornos relacionados al uso de sustancias psicoactivas, se asoció significativamente con el comportamiento sexual de riesgo, especialmente en los varones. Asimismo, se identificó que la mayor frecuencia de prácticas religiosas y el tener padres casados por lo civil tienen un efecto protector de las prácticas sexuales de riesgo.…”