The Prevalence of Psychiatric Disorders in Sexually Transmitted Disease Clinic Patients and Their Association With Sexually Transmitted Disease Risk

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Abstract
Psychiatric disorders could limit the success of behavioral counseling strategies. We evaluated the prevalence of psychiatric disorders among sexually transmitted disease (STD) clinic patients and their association with STD risk. A systematic sample of 201 patients presenting to a public STD clinic in Baltimore, Maryland, participated in the structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Overall, 45% of 201 STD clinic patients interviewed had a current axis I disorder and 29% had an axis II personality disorder. Substance use disorders predominated among axis I diagnoses; antisocial personality disorder (ASPD) predominated among axis II diagnoses, with an ASPD prevalence of 29.4% in men. ASPD was associated with a diagnosis of an STD (odds ratio, 3.67; 95% confidence interval, 1.63-8.30; P = 0.002). Substance use was not associated with an STD diagnosis. STD clinic patients have complex psychopathology that could increase HIV risk and compromise prevention interventions. Specialized counseling strategies, particularly targeting personality traits of ASPD, could improve prevention outcomes.

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