Meade Christina S, Graff Fiona S, Griffin Margaret L, Weiss Roger D
Department of Psychiatry, Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Drug Alcohol Depend. 2008 Jan 1;92(1-3):296-300. doi: 10.1016/j.drugalcdep.2007.07.013. Epub 2007 Sep 11.
Bipolar and substance use disorders frequently co-occur, and both are associated with impulsivity, impaired judgment, and risk-taking.
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.
Participants (N=101) were assessed for psychiatric diagnoses, substance abuse, and HIV risk behavior using structured clinical interviews and self-report questionnaires.
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.
Results underscore the importance of HIV prevention for this population.
双相情感障碍与物质使用障碍经常同时出现，且二者均与冲动性、判断力受损和冒险行为有关。
本研究旨在：（1）描述双相情感障碍与物质使用障碍共病患者中艾滋病病毒（HIV）性传播和药物相关风险行为的发生率，（2）检验急性躁狂、精神疾病严重程度和药物使用严重程度是否能独立预测HIV风险，以及（3）研究特定物质依赖与性风险行为之间的关系。
使用结构化临床访谈和自我报告问卷对101名参与者进行精神疾病诊断、药物滥用和HIV风险行为评估。
大多数人（75%）在过去6个月中有性行为，且报告了较高的性风险行为发生率，包括无保护性行为（69%）、多个性伴侣（39%）、与妓女发生性行为（仅男性为24%）和性交易（10%）。在多变量线性回归模型中，近期躁狂发作、较低的精神疾病严重程度和较高的药物使用严重程度是HIV总体风险的独立预测因素。可卡因依赖与性交易风险增加有关。
研究结果强调了针对该人群进行HIV预防的重要性。
