ABSTRACT
BACKGROUND: Nearly 3% of Americans experience severe and persistent mental illness (SPMI) and behaviors that place affected individuals at risk for sexually transmitted infections (STIs) are common. Few data describe the prevalence of risk behaviors or STI among persons with SPMI. We aim to quantitate STI/human immunodeficiency virus risk and determine the STI prevalence amongst outpatient psychiatric clinic attendees. METHODS: Psychiatric outpatients were approached to participate in an interviewer-administered survey collecting data on their sexual history, psychiatric history, and risk behaviors. Females submitted self-collected vaginal swabs, whereas males submitted urine to be tested for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis (women only). RESULTS: The prevalence of N. gonorrhoeae was 1%, C. trachomatis 3.3% and T. vaginalis 15.7%. Exchanging sex for drugs was the only behavior independently associated with having an STI in this population. CONCLUSIONS: Taking a sexual history in persons with SPMI is important. Those engaging in high-risk behavior should be routinely screened for STI/human immunodeficiency virus allowing for detection, treatment, and preventive education.
Subject(s)
Ambulatory Care Facilities , Health Surveys , Mental Disorders/complications , Risk-Taking , Sexual Behavior , Sexually Transmitted Diseases/epidemiology , Adult , Animals , Bipolar Disorder/complications , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Chlamydia Infections/microbiology , Chlamydia trachomatis/isolation & purification , Female , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Gonorrhea/microbiology , Humans , Interviews as Topic , Male , Mentally Ill Persons , Middle Aged , Neisseria gonorrhoeae/isolation & purification , Prevalence , Psychiatry , Psychotic Disorders/complications , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/etiology , Trichomonas Vaginitis/diagnosis , Trichomonas Vaginitis/epidemiology , Trichomonas Vaginitis/parasitology , Trichomonas vaginalis/isolation & purificationABSTRACT
OBJECTIVE: HIV primary care clinics offer an environment in which to deliver prevention messages and to conduct sexually transmitted disease (STD) screening. Determination of the prevalence and factors associated with risk-taking behaviors among HIV clinic attendees is needed. GOAL: The goal of this study was to describe risk behaviors and STD prevalence in males receiving HIV primary care. STUDY: Participants underwent an interviewer-administered survey and STD testing during this cross-sectional study. RESULTS: Over two thirds of study participants reported sexual activity within the prior 6 months of which 6% were infected with gonorrhea or chlamydia. Men performing insertive rectal sex were 5 times less likely to use condoms when the partner was HIV-positive (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.90-13.91), whereas patients with higher CD4 counts were more likely to engage in unprotected receptive rectal sex (OR, 1.20; 95% CI, 1.02-1.42). CONCLUSION: HIV primary care clinics provide access to patients in need of HIV prevention intervention and are appropriate sites for these activities.
