The Relationship of Manic Episodes and Drug Abuse to Sexual Risk Behavior in Patients with Co-Occurring Bipolar and Substance Use Disorders: a 15-Month Prospective Analysis
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Risky sexual behavior is common among individuals with bipolar and substance use disorders. This 15-month prospective study examined the effects of between-subject differences and within-subject changes in mood symptoms and drug use on sexual risk behavior among 61 patients with both disorders. Participants completed five post-treatment follow-up assessments at 3-month intervals. Using a multivariate mixed-effects model analysis, more average weeks of mania (between-subject difference) was associated with greater sexual risk, but change in weeks of mania (within-subject change) was not; depression was unrelated to sexual risk. In addition, within-subject increases in days of cocaine use predicted increases in sexual risk. Results underscore the importance of substance abuse treatment and suggest that bipolar patients with active and/or recurrent mania are in need of targeted HIV prevention services. Further research is needed to test whether individual differences in impulsivity may explain the association between mania and sexual risk.
KeywordsSexual risk behavior Bipolar disorder Substance dependence Mania Cocaine
This study was supported by the following grants from National Institutes of Health: R01 DA15968 (Weiss), T32-DA01536 (Lukas), P30-AI064518 (Weinhold), and K24-DA022288 (Weiss). Results of this study were presented at the XVIII International AIDS Conference in Vienna, Austria on July 21, 2010.
- 3.American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. (text revision). Washington, DC: American Psychiatric Association; 2000.Google Scholar
- 4.Sacks M, Dermatis H, Burton W, Hull J. Acute psychiatric illness: effects on HIV-risk behavior. Psychosocial Rehabil J. 1994;17(4):14–9.Google Scholar
- 5.McDermott BE, Sautter FJ Jr, Winstead DK, Quirk T. Diagnosis, health beliefs, and risk of HIV infection in psychaitric patients. Hosp Commun Psychiatry. 1994;46(6):580–5.Google Scholar
- 13.Metzger DS, Nalvaline HA, Woody GE. Assessment of substance abuse: HIV risk assessment battery. In: Carson-Dewitt R, editor. Encyclopedia of drugs, alcohol, and addictive behavior. Framington Hills, MI: Macmillan Reference USA; 2001.Google Scholar
- 15.Sobell LC, Sobell MB. Timeline follow-back user’s guide: a calendar method for assessing alcohol and drug use. Toronto: Addiction Research Foundation; 1996.Google Scholar
- 23.Goodman LA, Fallot RD. HIV risk-behavior in poor urban women with serious mental illness: association with childhood physical and sexual abuse. 1998;68(1):73–83.Google Scholar