Borderline Personality Disorder Symptom Severity and Sexually Transmitted Infection and HIV Risk in African American Incarcerated Men.
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.
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.
Joy D
JD
Scheidell
Carl W
CW
Lejuez
Carol E
CE
Golin
Marcia M
MM
Hobbs
David A
DA
Wohl
Adaora A
AA
Adimora
Maria R
MR
Khan
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D001883:Borderline Personality Disorder / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D011329:Prisoners / Q000523:psychology; D011330:Prisons; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult