AIDS and Behavior

, Volume 15, Issue 8, pp 1829–1833 | Cite as

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

  • Christina S. MeadeEmail author
  • Garrett M. Fitzmaurice
  • Amy K. Sanchez
  • Margaret L. Griffin
  • Leah J. McDonald
  • Roger D. Weiss
Original Paper


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.


Sexual 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.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Christina S. Meade
    • 1
    • 2
    Email author
  • Garrett M. Fitzmaurice
    • 3
    • 4
  • Amy K. Sanchez
    • 5
  • Margaret L. Griffin
    • 3
    • 4
  • Leah J. McDonald
    • 4
  • Roger D. Weiss
    • 3
    • 4
  1. 1.Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamUSA
  2. 2.Duke Global Health InstituteDurhamUSA
  3. 3.Department of PsychiatryHarvard Medical SchoolBostonUSA
  4. 4.Alcohol and Drug Abuse Treatment ProgramMcLean HospitalBelmontUSA
  5. 5.Department of Psychology and NeuroscienceDuke UniversityDurhamUSA

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