Role of IPV, HIV and Substance Abuse in Mental Health of African American Women

Johns Hopkins University, Baltimore MD

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Abstract

DESCRIPTION (provided by applicant): While the significant impact of intimate partner violence (IPV), HIV/AIDS and substance abuse on health has been documented, no studies have evaluated the combined and co-occurring, or syndemic, effect of these three public health issues on mental health outcomes of African American urban women. The broad, long- term objective of this research is to understand the impact of the substance abuse, HIV/AIDS and IPV (SAVA) syndemic on urban African American women, who are particularly vulnerable to these health issues, and identify modifiable factors that could improve mental health outcomes. The identification of protective factors against poor mental health outcomes is crucial to develop interventions and services to reduce psychiatric morbidity associated with the SAVA syndemic. Social support could function as a moderator of the negative mental health effects of the SAVA syndemic because of its documented buffering effect between trauma and mental health. However, the moderating effect of different types of social support (i.e. emotional, instrumental, informational;enacted, perceived) on the relationship between the SAVA syndemic and mental health outcomes has not been investigated in this population. Therefore, the specific aims of this project are to 1) determine the prevalence of the SAVA syndemic among a sample of urban African American women;2) examine the relationship between the SAVA syndemic and depression and PTSD;and 3) evaluate the effect of differing types of social support as moderators in the relationship between the SAVA syndemic and depression and PTSD. These goals will be achieved by analyzing cross sectional baseline interview data from a parent study that aims to implement and evaluate an intervention to reduce depressive symptoms and HIV risk behaviors among drug users. For the purposes of this study, women of similar sociodemographic background who are non-drug users will be enrolled and interviewed as well. Data on HIV status, substance use, IPV experience, types of social support, depression, PTSD, and other sociodemographic risk factors will be collected and analyzed to address the specific aims of this study using bivariate and multiple logistic regression analyses. Relevance to Public Health: This research will contribute to public health efforts to reduce poor mental health outcomes associated with HIV, IPV and substance abuse by determining the impact of these problems as they co-occur on the mental health of urban African American women. It will identify and assess types of social support that could protect this population from associated depression and PTSD. This knowledge could lead to the development of effective interventions and mental health services for women living with HIV, IPV and substance abuse.