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Intentional self-injection with HIV.

To the Editor. —Several workers have expressed concern that psychopathology may play a predisposing role in the acquisition of human immunodeficiency virus (HIV) infection.1,2We have recently encountered an unusual case that illustrates an extreme example of the role of psychopathology as a risk factor for HIV infection. A 45-year-old female laboratory technologist was seen in consultation for repeated intentional self-injection with hazardous biomaterials. She had a long psychiatric history marked by repeated suicide attempts, impulsive and occasionally violent acts, and dissociative episodes, all compatible with borderline personality disorder. In early 1989, after nearly 15 years of minimal psychiatric difficulties, increased domestic strife led to a resurgence of symptoms that necessitated psychiatric hospitalization. Her anxiety, dysphoria, dissociation, and suicidal tendencies, in the absence of any evidence of psychosis, were treated with 12 mg/d of perphenazine for several months with seemingly good response. During a work pass arranged in preparation