Variables related with risk-taking behavior for HIV transmission in intravenous drug users

Aims: To determine the factors associated with the maintenance of HIV-related risk behaviours lit opiate patients dependent and establish whether psychopathology and more specifically personality disorders are part of them. Design: Cross-sectional study with descriptive and analytical elements. Setting: The inpatient Drug-Dependence Unit of the Psychiatry Department at the Hospital Clinico Universitario in Valencia, Spain. Study sample: Study subjects (n=110) were consecutive first nti,admissions to tbe Drug-Dependence Unit, Instruments: The following instruments were used a structured clinical history a Questionnaire on HIV-related risk behaviours, the Symptom Checklist-90 (SCL-90), the Beck Depression Inventory (BDI), and the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). Results: Patients who had HIV-related risk behaviours were younger (C195 % = 0.43-3.99) and showed a younger age of first heroin and cocaine use. An association was found between a maintenance of risk behaviours and a current cocaine dependence (OR=2.39; C195%=1.04-5.48), a current benzodiacepine dependence (OR=6.81; C195% =2. 67-17.38) and being HIV positive (OR=2.5; C195%=1.10-5.67). An association was also found between HIV-related risk behaviours and the number of prior drug-related hospital admissions. The maintenance of risk behaviours was associated with the presence of personality disorders (OR=2.63; C195%=1.18-5.84) and particularly with the antisocial personality disorder (OR=3.75; C195%=1.61-8.75). The logistic regression analysis showed that the existence of benzodiacepine dependence, cocaine dependence, antisocial personality, disorder and the number of drug-related admissions classified correctly 81.08% of patients. Conclusions: The higher severity of patients that maintained HIV-related risk behaviours and the association found with personality disorders suggests the need of designing more efficient therapeutic strategies for a subpopulation of drug misusers that showing HIV-related risk behaviours.