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LH Bachmann 1,2 , J Feldman 1 , Y Waithaka 1 and EW Hook III 1

Sexual Risk Behaviors and Sexually Transmitted Infection (STI) Prevalence in an Outpatient Psychiatry Clinic. LH Bachmann 1,2 , J Feldman 1 , Y Waithaka 1 and EW Hook III 1 1 University of Alabama at Birmingham, Birmingham, AL;

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LH Bachmann 1,2 , J Feldman 1 , Y Waithaka 1 and EW Hook III 1

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  1. Sexual Risk Behaviors and Sexually Transmitted Infection (STI) Prevalence in an Outpatient Psychiatry Clinic LH Bachmann1,2, J Feldman1, Y Waithaka1 and EW Hook III1 1University of Alabama at Birmingham, Birmingham, AL; 2Birmingham Veterans Administration Medical Center, Birmingham, AL

  2. Background • 1 in 5 Americans will have a diagnosable mental disorder during the course of a year • 5% of adults have serious mental illness • Mental illness may result in behaviors that place patients at risk for STI acquisition • Few data are available regarding sexual risk behavior and STI prevalence among patients receiving care for chronic mental illness

  3. Objectives • To determine sexual and substance use risk behaviors in patients receiving care at the University of Alabama at Birmingham (UAB) Community Care Psychiatric Outpatient Clinic • To determine the prevalence of C. trachomatis, N. gonorrhoeae, and T. vaginalis in this population

  4. Methods • Beginning July 2003, male and female patients between 18 and 50 years of age were consecutively approached for study participation • Consenting participants underwent an interviewer-administered survey • Chart review was performed for DSM-IV diagnoses

  5. Methods • Urine (male) or self-obtained vaginal swabs (female) were obtained for nucleic acid amplification (GenProbe Aptima Combo 2) testing for C. trachomatis and N. gonorrhoeae • Women submitted self-obtained vaginal swabs for T. vaginalis culture • Patients identified with infection were treated according to the 2002 CDC STD Treatment Guidelines

  6. Analyses Statistical analyses were performed using SAS version 9. For categorical variables, Mantel-Haentszel chi-squared analysis and Fisher’s Exact tests were used as appropriate. For continuous variables, t tests were used to compare means between groups. P<0.05 was considered significant

  7. Study Population N = 275

  8. Study Population N = 275* (Cont’d)

  9. DSM-IV Diagnosis by Gender N=259*

  10. Stability Indicators • Psychiatric hospitalization since last visit – 18 (7%) • Emergency Department since last visit – 34 (13%) • Jail since last visit – 7 (3%)

  11. Reported Sexual BehaviorsN=259

  12. Substance Use Behavior

  13. STI Prevalence

  14. Conclusions • Sexual behavior was heterogeneous in this chronically mental ill population • 1 in 10 patients were infected with an STI, with almost a quarter of cases in patients who denied sexual activity in more than 6 mo • Symptoms were not predictive of STI in men

  15. Conclusions • Race was the only significant predictor of infected status • Routine STI screening in this setting may reach a group of individuals not captured through other methods

  16. Acknowledgements • Rosalyn Mallory • Prashant Tayshetye • Coretta Thomas • Olivio Clay • Sharron Hagy • Marga Jones

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