title: Perceived mental illness stigma, intimate relationships and sexual risk behavior in youth with mental illness.
abstract: The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted in-depth interviews with N=20 youth with mental illness (MI) (55% male, 16-24 years, 75% Latino) from 4 psychiatric outpatient clinics in New York City. We conducted a thematic analysis to investigate shared experiences of MI stigma and its impact on youth's sexual or romantic relationships and associated behaviors. Our analysis revealed four main themes: 1) societal perceptions of those with MI as partners (societal stigma); 2) individual experiences of stigma within relationships (individual level); 3) internalized stigma of self as a partner (social-psychological processes); and 4) managing a stigmatized identity, of which some of the behaviors directly placed them at increased risk for HIV. We found that just under half of the sample (n=9/20) endorsed all themes, including engaging in HIV/STI sexual risk behaviors as a method to manage a stigmatize identity, which suggests that MI stigma and sexual risk may be linked. We discuss differences by gender and diagnosis. Findings provide new information for providers and researchers to address on the role of stigma experiences in the romantic and sexual behavior of youth in psychiatric treatment. Implications for stigma and HIV/STI prevention interventions are discussed.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute (NYSPI) and Columbia University, NY, NY.
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Elkington
authors.affiliation: Columbia Mental Health HIV Training Project, New York State Psychiatric Institute, NY, NY.
authors.forename: Dusty
authors.initials: D
authors.lastname: Hackler
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute (NYSPI) and Columbia University, NY, NY ; Mailman School of Public Health, Columbia University, NY, NY.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Walsh
authors.affiliation: Department of Psychology, State University of New York at Stony Brook, NY.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Latack
authors.affiliation: Columbia Mental Health HIV Training Project, New York State Psychiatric Institute, NY, NY.
authors.forename: Karen
authors.initials: K
authors.lastname: McKinnon
authors.affiliation: Columbia Mental Health HIV Training Project, New York State Psychiatric Institute, NY, NY.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Borges
authors.affiliation: Department of Public Health, IU School of Medicine, Indiana University-Purdue University Indianapolis, IN.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Wright
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute (NYSPI) and Columbia University, NY, NY ; Columbia Mental Health HIV Training Project, New York State Psychiatric Institute, NY, NY.
authors.forename: Milton L
authors.initials: ML
authors.lastname: Wainberg
keywords: mental illness-related stigma; psychiatric disorders; romantic relationships; sexual risk behavior; youth