Sexual Risk Behaviors and Sexually Transmitted Infection Prevalence in an Outpatient Psychiatry Clinic

The authors report that almost 3 percent of Americans experience severe and persistent mental illness (SPMI). Behaviors that put these individuals at risk of sexually transmitted infections (STIs) are commonplace, yet few data describe the prevalence of risk behaviors or STIs among persons affected by SPMI. In the current study, the researchers sought to quantitate the risk of STI and HIV and to determine STI prevalence among attendees at an outpatient psychiatric clinic.

Outpatients were approached to participate in an interviewer-administered survey collecting data on sexual history, psychiatric history, and risk behaviors. Females submitted self-collected vaginal swabs; males submitted urine for testing.

The specimens were tested for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis (women only). Testing revealed the following prevalence levels: N. gonorrhoeae, 1 percent; C. trachomatis, 3.3 percent; T. vaginalis, 15.7 percent. In this population, exchanging sex for drugs was the only behavior independently associated with having an STI.

"Taking a sexual history in persons with SPMI is important," the authors concluded. "Those engaging in high-risk behavior should be routinely screened for [STI/HIV] allowing for detection, treatment, and preventive education."

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