Behavioral health, and HIV/HCV risk behavior among young African American IDUs

Objective: To examine the relationship between behavioral health and HIV/HCV risk behaviors in young African American IDUs. Methods: IDUs, ages 16-30, participants in a NIDA-funded HIV/HCV risk reduction intervention completed the Brief Symptom Inventory (BSI) and were interviewed about mental health history and HIV/HCV sexual and drug use risk behaviors. Participants were asked if they had been hospitalized in a mental health ward and if they had thoughts of suicide during the prior 6 months. BSI scores measured symptom severity and 9 symptom sub-scales. Risk behaviors examined included condom use and direct and indirect syringe sharing practices. Results: Of 211 participants, 94% were male, mean age 24 years. At baseline 32% reported contemplating suicide, 57% endorsed psychological symptoms, and 21.4% indicated hospitalization in a mental health ward. IDUs with mental health hospitalization were more likely to report sharing syringes (OR 2.58; 95%CI, 2.29-2.93), and sharing cookers, cotton and/or rinse water (OR 2.45; 95%CI, 2.17-2.80), IDUs with elevated scores on the BSI were more likely to report sharing syringes (OR 2.38; 95%CI, 2.12-2.68) and sharing cookers, cotton and/or rinse water (OR 2.48; 95%CI, 2.21-2.81). IDUs with suicidal ideation were more likely to report sharing syringes (OR 2.81; 95%CI, 2.51-3.16), and sharing cookers, cotton and/or rinse water (OR 2.56; 95%CI, 2.30-2.87). Behavioral health was not significantly associated with sexual risk behavior. Conclusions: These findings indicate that it is important to consider the co-morbidity of behavioral health problems in the design and implementation of HIV/HCV prevention and intervention programs targeting young IDUs.