HIV and Personality Disorders

High-Risk Behavior and Disease Susceptibility

By: THEODORE MILLON and

      Seth Grossman

      Carrie Millon

      Sarah Meagher

      Rowena Ramnath

Personality disorders are more common among those infected with Human Immunodeficiency Virus (HIV), with borderline personality being one of the most frequent.

For example, Perkins, Davidson, Leserman, Liao, and Evans (1993) found a higher prevalence of personality disorder among HIV-positive than HIV-negative subjects, with borderline the principal diagnosis.

Later studies have supported this finding. In a longitudinal study, Jacobsberg, Frances, and Perry (1995) discovered that almost two-fifths of subjects who tested seropositive could be diagnosed with a personality disorder. Among subjects who did not know their HIV status, significantly more HIV-positive than HIV-negative subjects could be diagnosed as borderlines

Others have found that personality disorders and other serious mental conditions may impair self-assessment of risk and reduce the effectiveness of educational programs (Knox, Boaz, Friedrich, & Dow, 1994).

Why would HIV and personality disorder go together?

Personality disorders are often linked to impulsivity, and impulsivity is linked to high-risk behaviors. By definition, impulsive individuals fail to think through the consequences of their actions.

·         Borderlines, for example, are famous for sudden shifts of emotion and impulsive actions, including spending sprees and heavy alcohol and substance abuse. Moreover, impulsivity is linked to unprotected sex and multiple sexual partners, a principal way through which HIV is spread.

·         Likewise, a significantly greater proportion of subjects with antisocial personality disorder engage in needle sharing than those without antisocial personality disorder.

Further research will be necessary to test additional hypotheses linking the personality disorders with HIV infection.

·         For example, it is possible that some narcissistic personalities feel a special sense of invulnerability or that they are “above” using a condom.

·         Dependent personalities might be reluctant to refuse a partner who desires unprotected sex.

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·         Individuals with sadistic traits might deliberately infect others.

·         Antisocials might lie about their sexual history or HIV status.

Because casual sex is common in our society, those who practice it are obliged to size up their partners for traits that might be linked to high-risk behaviors.

References

Personality Disorders in Modern Life, second edition, 2000, 2004 by John Wiley & Sons, Inc

Read Also

Narcissistic Personality Disorder, Case vignette (1)
Narcissistic Personality Disorder, Case vignette (2)
Narcissistic Personality Disorder, Case vignette (3)
Borderline Personality Disorder, Case vignette (1)
Borderline Personality Disorder, Case vignette (2)
Borderline Personality Disorder, Case vignette (3)
Antisocial Personality Disorder, Case vignette (1)
Antisocial Personality Disorder, Case vignette (2)
Antisocial Personality Disorder, Case vignette (3)

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