Teens Who Repeatedly Cut Themselves Have Greater HIV Risk

Researchers from the Bradley Hasbro Children's Research Center in Providence, R.I. report that frequent self-cutters -- teens who have cut themselves more than three times -- used condoms less consistently, were more likely to share cutting instruments, and had less self-restraint. The study is the first to examine whether these teens engage in the same level of risk behaviors as those who've only experimented with cutting once or twice.

"This study sheds some much-needed light on the relationship between frequency of self-cutting and sexual risk, which could prove critical, given the rising rates of self-injury among adolescents," says lead author Larry K. Brown, M.D., of the Bradley Hasbro Children's Research Center (BHCRC). "Basically, we found that greater frequency seems to imply greater HIV risk, as these teens were more likely to share cutting instruments and participate in other risky activities that can expose them to HIV and other diseases."

"The associations between frequent cutting, sexual risk and low self-restraint provide clues to the forces that underlie this repeated behavior and point us in the right direction for future research to better understand this troubling and self-destructive phenomenon," adds Brown, who's also a professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University.

More than 100 teenagers (ages 11 to 18) from intensive psychiatric treatment programs with a history of cutting completed a series of questionnaires to gauge self-cutting practices, sexual risk behaviors and risk attitudes. More than half of these teens were female, the majority was white, and 48 percent had a primary diagnosis of a mood disorder. None of the teens reported an HIV infection.

Approximately 39 percent engaged in frequent cutting, averaging about 19 cutting episodes per person. Nearly three-quarters of these frequent cutters were teenage girls but more than a quarter were non-white -- a surprising finding, given the study population. Those with a history of sexual abuse were also more likely to cut frequently.

Overall, 68 percent of teens in the study were sexually active, although just 39 percent of frequent cutters said they used condoms consistently in the past 90 days -- nearly half that of infrequent cutters. Teens who frequently cut themselves were also four times more likely to share their cutting instruments than non-frequent cutters and they also exhibited less self-restraint.

"This study found important differences between self-cutters based on the frequency of their cutting. Although it appears that infrequent cutters are more 'experimental' and more like their peers who do not cut, teens who cut themselves frequently should be referred for additional psychiatric evaluation to address their sexual risk behaviors and minimize their HIV risk," says Brown.

The study was supposed by a grant from the National Institute of Mental Health. Co-authors were Christopher D. Houck, Ph.D., and Celia M. Lescano, Ph.D., from the BHCRC and Alpert Medical School; Cynthia I. Grossman, Ph.D., previously with the BHCRC and currently with the National Institute of Mental Health; and Jennifer L. Frenkel, B.A., previously with BHCRC and currently with The Johns Hopkins University.