Borderline Personality Disorder symptoms and HIV risk behaviors among African-American incarcerated men

Abstract

Aims: In order to expand HIV epidemiology knowledge regarding the influence of psychopathology, we assessed associations between Borderline Personality Disorder (BPD) symptoms and HIV risk behaviors among incarceratedmen. BPD is not typically examined by HIV epidemiologists or in males. Methods: Data were collected during the baseline (in-prison) survey of Project DISRUPT, an ongoing cohort study of African American men being released from prison in North Carolina who were in primary committed relationships at the time of incarceration (n=159). We assessed drug use and sexual risk in the six months before incarceration and BPD symptoms using a five item scale measuring the severity of distress/problems over the past 30 days causedbybehaviors suchasworry that someone is planning to leave you; those scoring in the 75th percentile were considered to have elevated BPD symptoms. Associations between elevated BPD symptoms and drug and sex risk outcomes were estimated. Results: After adjusting for age, pre-incarceration concern about being able to pay bills, and depressive symptoms, BPD symptoms were associated with multiple partnerships (OR 3.17, 95fl CI: 1.33–7.58), concurrent sex partnerships (OR: 3.42, 95fl CI: 1.48–7.91), drug use with sex partners (OR 5.24, 95fl CI: 1.29–21.39), having sex while high (OR 3.88, 95fl CI: 1.45–10.38), crack/cocaine use (OR 4.66, 95fl CI 1.62–13.45), and ecstasy use (OR 4.43, 95fl CI 1.39–14.10). Associations between BPD symptoms and sex risk variables were attenuated but remained significant when controlling for crack/cocaine and ecstasy use, suggesting BPD symptomsmay increase sex risk in part by contributing to drug use. Conclusions: BPD symptomology is a strong HIV risk correlate and should be considered in future HIV prevention studies among men. Financial support: NIDA R01DA028766. The content does not necessarily represent the views of NIDA.