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Meade, Graff, Griffin, and Weiss (2008) assessed 101 adults with co-occurring bipolar disorder (BD) and substance use disorder (SUD). This sample of convenience included 47 men and 54 women who were primarily white and well-educated. "For [those with] BD diagnoses, 81% had bipolar I, 16% bipolar II, and 3% bipolar not otherwise specified. Most (84%) experienced a mood episode within the past month, and 49% were categorized as having a recent manic episode. All participants had a substance dependence disorder: 25% both drug and alcohol, 50% alcohol alone, and 25% drug alone. Among drug dependent participants, the most common primary drugs were cocaine (41%) and marijuana (41%)" (p. 297). Meade and colleagues found that, among these study participants, "[t]he majority (75%) were sexually active in the past 6 months and reported high rates of sexual risk behaviors, including unprotected intercourse (69%), multiple partners (39%), sex with prostitutes (24%, men only), and sex trading (10%). In a multivariate linear regression model, recent manic episode, lower psychiatric severity, and greater drug severity were independent predictors of total HIV risk. Cocaine dependence was associated with increased risk of sex trading" (p. 296). The investigators conclude that "acute mania and cocaine dependence seem to be risk factors for sexual risk behavior" (p. 298) and observe that "persons with co-occurring BD and SUD are in need of targeted HIV prevention services, particularly sexual risk reduction" (p. 299).
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Spring 2008 Newsletter / Volume 9, Issue 3
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