Substance use and psychopathology in African American men at risk for HIV infection

Recent epidemiologic surveys of the prevalence of and primary risk factors for psychiatric morbidity suggest that socioeconomic status, age, ethnicity and gender represent significant risk factors for both primary Psychiatric and substance use disorders. Further, evidence of concurrent disorders continues to mount, particularly among inpatients. The present study is designed to address the association between heavy substance use and major mental disorders in a large sample of non-HIV-infected community-resident African American men. Three hundred eleven seronegative participants in a study of neurobehavioral sequelae of substance use and HIV in African American men in the metropolitan Los Angeles area were used to investigate the relative contribution of substance use and other cofactors in predicting psychiatric morbidity. Results indicate significantly higher rates of 30-day and 12-month Axis I disorders in this sample than reported in the most recent epidemiologic studies, but consistent with rates observed in seronegative subjects in other HIV/AIDS studies. Further, positive associations between select indices of heavy substance use and both 30-day and 12-month psychopathology were found. Finally, heavy cocaine use was the primary predictor of mood disorder, whereas gay/bisexual orientation and prior history of psychopathology were the primary predictors of anxiety disorder and of any recent Axis I disorder. These findings are discussed in light of the primary goals of this community-based study. (C) 1997 John Wiley & Sons, Inc.