Borderline Personality in Prisoners Influences Sexually Transmitted Disease Rate

The first study to look at the relationship between sexually transmitted infections (STIs) and the severity of borderline personality disorder (BPD) symptoms came back with some staggering numbers.

STIs such as chlamydia, gonorrhea, and syphilis — as well as the human immunodeficiency virus (HIV) – are already more prevalent in incarcerated men than in the general population.

The diseases are eight to 18 times more common in African American inmates. Researchers from the New York University Langone (NYULMC) Department of Population Health and New York University’s Center for Drug Use and HIV Research (CDUHR) set out to find how BPD plays a role in the transmission of STIs.

“The period of incarceration has long been seen as a critical time for addressing public health concerns,” Joy Scheidell, MPH, from NYULMC, said in a news release.

BPD is characterized by a persistent pattern of instability when it comes to self-image, impulse control, and interpersonal relationships. Previous research indicates that BPD leads to more risky sexual behavior, which translates to STI transmission. However, most studies have focused on woman — leading to the estimate that up to 55% of incarcerated women have BPD. Around 20% of men in jail have the disorder, reports say.

The researchers used a database consisting of 189 heterosexual African American men who had been released from prison to assess their STI/HIV risk. The analysis, published in Sexually Transmitted Diseases, began six months prior to incarceration. The participants received BPD symptom severity scores and dichotomous BPD indicator to split at the top quartile (BPD-TQ).

STI prevalence was higher in those with BPD (47.5% vs. 29.6%), specifically for chlamydia (6.9% vs. 3.1%, respectively).

“At the aggregate level, we found participants in the top 25% of the scale measuring BPD symptom severity were substantially younger than those in the remaining 75%,” Scheidell continued. “Furthermore, those who fell within the top quartile exhibited twice the rate of depressive symptoms and reported far more instances of elevated stress.”

“With each unit increase in fear of abandonment came an almost 60% increase in the likelihood the participant engaged in sex with partners who sell sex,” added co-author Maria Khan, PhD, from CDUHR.

The findings suggest that it’s not enough to address STIs and HIV; mental health programs need to be strongly integrated into the criminal justice system to reduce incidence.