Substance use, mental illness, and familial conflict non-negotiation among HIV-positive African-Americans: latent class regression and a new syndemic framework

Research output: Contribution to journalArticle

Abstract

We evaluated a synergistic epidemic (syndemic) of substance use, mental illness, and familial conflict non-negotiation among HIV-positive injection drug users (IDU). Baseline BEACON study data was utilized. Latent class analyses identified syndemic classes. These classes were regressed on sex, viral suppression, and acute care non-utilization. Females were hypothesized to have higher syndemic burden, and worse health outcomes than males. Nine percent of participants had high substance use/mental illness prevalence (Class 4); 23 % had moderate levels of all factors (Class 3); 25 % had high mental illness (Class 2); 43 % had moderate substance use/mental illness (Class 1; N = 331). Compared to Classes 1–3, Class 4 was mostly female (p < .05), less likely to achieve viral suppression, and more likely to utilize acute care (p < .05). Interventions should target African-American IDU females to improve their risk of negative medical outcomes. Findings support comprehensive syndemic approaches to HIV interventions, rather than singular treatment methods.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalJournal of Behavioral Medicine
Volume39
Issue number1
DOIs
StatePublished - Feb 1 2016

Keywords

  • African-Americans
  • HIV
  • Health disparities
  • Health services research
  • Injection drug use
  • Syndemic theory
  • Viral suppression

ASJC Scopus subject areas

  • Psychology(all)
  • Psychiatry and Mental health

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