Antisocial personality in treatment-seeking cocaine abusers: Psychosocial functioning and HIV risk

Antisocial personality disorder (ASP) is common in substance abusers and may be associated with increased severity of psychosocial problems and risk of HIV infection. This study compared 174 treatment-seeking cocaine abusers with and without ASP on Addiction Severity Index (ASI) scores and the HIV risk behavior scale. Patients with ASP comprised 35% of the sample. These patients evidenced more severe problems than non-ASP patients on alcohol, legal, and psychiatric indices of the ASI. Patients with ASP also reported greater participation in lifetime sexual risk behaviors, including number of casual sexual partners, inconsistent condom use, and frequency of anal sex. This study suggests the importance of screening for ASP when patients initiate treatment. Specific and more intensive treatment may be necessary to improve outcomes in this patient population.