Mental health disorders and sexually transmitted diseases in a privately insured population

Am J Manag Care. 2004 Dec;10(12):917-24.


Objectives: To consider whether patients who use mental health services in privately insured settings are also more likely to have received sexually transmitted disease (STD) or human immunodeficiency virus (HIV) diagnoses and whether this relationship extends to patients with milder mental health disorders.

Methods: Using frequency tables stratified by age and sex, a logistic regression model, and difference of means tests, we examined the relationship between mental health claims and STDs in a sample of 289 604 privately insured people across the United States.

Results: Patients with mental health claims were more than twice as likely as other patients to have an STD claim in the same year after controlling for confounding factors (odds ratio, 2.33; 95% confidence interval, 2.11-2.58). This relationship held for severe and milder mental health diagnoses, for male and female patients, and in each age category from 15 to 44 years. Among women, patients aged 20 to 24 years with a mental health claim had the highest predicted probability of STD diagnoses (3.0%); among men, patients aged 25 to 29 years with a mental health claim had the highest predicted probability of STD diagnoses (1.2%).

Conclusions: In this population, patients with mental health claims were more likely to also have claims with diagnoses for STDs than patients without mental health claims, and this relationship applied to severe and milder mental health disorders. This suggests that people with mental health disorders in privately insured populations may benefit from routine STD risk assessments to identify high-risk patients for referral to cost-effective preventive services.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Comorbidity
  • Databases as Topic
  • Fee-for-Service Plans / statistics & numerical data*
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • Humans
  • Incidence
  • Insurance Claim Review
  • Male
  • Mass Screening
  • Mental Disorders / classification
  • Mental Disorders / complications
  • Mental Disorders / epidemiology*
  • Preferred Provider Organizations / statistics & numerical data*
  • Probability
  • Sexually Transmitted Diseases / classification
  • Sexually Transmitted Diseases / complications
  • Sexually Transmitted Diseases / epidemiology*
  • United States / epidemiology