Joy D Scheidell1, Carl W Lejuez, Carol E Golin, Marcia M Hobbs, David A Wohl, Adaora A Adimora, Maria R Khan. 1. From the *Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, New York, NY; †Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, MD; ‡Division of General Internal Medicine and Epidemiology, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; §Department of Health Behavior, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; ¶Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; and ∥Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
BACKGROUND: Sexually transmitted infections (STI)/HIV rates are disproportionately high among men involved in the criminal justice system. Mental health disorders, including personality disorders, are also elevated among inmates. Borderline personality disorder (BPD) may be an important risk factor for STI/HIV, yet remains relatively understudied, particularly among inmates. METHODS: We used baseline data from Project DISRUPT, a cohort study of African American men being released from prison in North Carolina who were in heterosexual relationships at prison entry (n=189), to assess their STI/HIV risk in the 6 months before incarceration and BPD symptoms focused on emotional lability and relationship dysfunction. We created a continuous BPD symptom severity score and a dichotomous BPD indicator split at the top quartile of the score (BPD-TQ) to examine associations between BPD and STI/HIV outcomes using logistic regression. We also examined associations between individual symptoms and outcomes. RESULTS: After adjustment for sociodemographics and antisocial personality disorder, BPD-TQ was associated with sexual risk behaviors including multiple partnerships (adjusted odds ratio, 2.58; 95% confidence interval, 1.24-5.36) and sex with nonmonogamous partners (adjusted odds ratio, 2.54; 95% confidence interval, 1.17-5.51). Prevalence of previous STI (47.5% vs. 29.6%) and prevalent chlamydial infection (6.9% vs. 3.1%) seemed higher in those in BPD-TQ, although the associations were not statistically significant. Associations were similar to those with the continuous score. Borderline personality disorder symptoms most associated with STI/HIV risk were abandonment worry, mood swings, and shifts in opinions. CONCLUSIONS: Borderline personality disorder is strongly associated with STI/HIV risk in this sample. Researchers should further evaluate the relationship between STI/HIV and BPD, in addition to mood disorders.
BACKGROUND: Sexually transmitted infections (STI)/HIV rates are disproportionately high among men involved in the criminal justice system. Mental health disorders, including personality disorders, are also elevated among inmates. Borderline personality disorder (BPD) may be an important risk factor for STI/HIV, yet remains relatively understudied, particularly among inmates. METHODS: We used baseline data from Project DISRUPT, a cohort study of African American men being released from prison in North Carolina who were in heterosexual relationships at prison entry (n=189), to assess their STI/HIV risk in the 6 months before incarceration and BPD symptoms focused on emotional lability and relationship dysfunction. We created a continuous BPD symptom severity score and a dichotomous BPD indicator split at the top quartile of the score (BPD-TQ) to examine associations between BPD and STI/HIV outcomes using logistic regression. We also examined associations between individual symptoms and outcomes. RESULTS: After adjustment for sociodemographics and antisocial personality disorder, BPD-TQ was associated with sexual risk behaviors including multiple partnerships (adjusted odds ratio, 2.58; 95% confidence interval, 1.24-5.36) and sex with nonmonogamous partners (adjusted odds ratio, 2.54; 95% confidence interval, 1.17-5.51). Prevalence of previous STI (47.5% vs. 29.6%) and prevalent chlamydial infection (6.9% vs. 3.1%) seemed higher in those in BPD-TQ, although the associations were not statistically significant. Associations were similar to those with the continuous score. Borderline personality disorder symptoms most associated with STI/HIV risk were abandonment worry, mood swings, and shifts in opinions. CONCLUSIONS:Borderline personality disorder is strongly associated with STI/HIV risk in this sample. Researchers should further evaluate the relationship between STI/HIV and BPD, in addition to mood disorders.
Authors: Nancee Blum; Don St John; Bruce Pfohl; Scott Stuart; Brett McCormick; Jeff Allen; Stephan Arndt; Donald W Black Journal: Am J Psychiatry Date: 2008-02-15 Impact factor: 18.112
Authors: M R Khan; C E Golin; S R Friedman; J D Scheidell; A A Adimora; S Judon-Monk; M M Hobbs; G Dockery; S Griffin; K K Oza; D Myers; H Hu; K P Medina; D A Wohl Journal: AIDS Behav Date: 2015-08
Authors: Donald W Black; Tracy Gunter; Jeff Allen; Nancee Blum; Stephan Arndt; Gloria Wenman; Bruce Sieleni Journal: Compr Psychiatry Date: 2007-07-05 Impact factor: 3.735
Authors: Maria R Khan; Joy D Scheidell; Carol E Golin; Samuel R Friedman; Adaora A Adimora; Carl W Lejuez; Hui Hu; Kelly Quinn; David A Wohl Journal: J Urban Health Date: 2018-08 Impact factor: 3.671
Authors: Faith A Scanlon; Joy D Scheidell; Gary S Cuddeback; Darcy Samuelsohn; David A Wohl; Carl W Lejuez; William W Latimer; Maria R Khan Journal: J Correct Health Care Date: 2018-07-01