Mild to moderate mental illness and sexually transmitted diseases

Background: Severe mental illness (SMI) has been associated with an increased risk of having a sexually transmitted disease (STD), due to risk factors that include substance abuse and increased risk of sexual violence. As a result, STD prevention programs are targeted toward those with SMI. While people with mild to moderate mental illness (MMMI) are also at higher risk for sexual violence, limited information is available on MMMI and STDs. Therefore, we analyzed national survey data to determine the prevalence of STDs among those with MMMI.

Methods: Data from the 2003-2007 NHIS were analyzed to determine the association between STDs and MMMI. The Kessler psychological distress scale (K6) was used to identify individuals with probable MMMI and SMI based on level of psychological distress. Multivariate analysis was used to assess the association between STDs and MMMI.

Results: People with MMMI have a higher prevalence of STDs (4.8%) than people without probable mental illness (1.9%), but lower than those with SMI (6.7%). In multivariate analysis controlling for demographics and risk factors such as drinking and smoking status, the adjusted odds ratio (aOR) of having an STD for a respondent with MMMI was 1.6 (95% CI 1.4, 2.0), while the aOR of a respondent with SMI having an STD was 1.7 (95% CI 1.3, 2.3), both compared to respondents without probable mental illness.

Conclusions: People with MMMI were found to be at a similarly increased risk of having an STD as those with SMI and therefore could benefit from STD prevention programs.