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Stewart B, Byrne M, Levy M, Horberg MA, Monroe AK, Castel AD. The Association of Mental Health and Substance Use With Retention in HIV Care Among Black Women in Washington, District of Columbia. Womens Health Issues 2024; 34:250-256. [PMID: 38184379 PMCID: PMC11116077 DOI: 10.1016/j.whi.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Black women with HIV are impacted by mental health and substance use disorders alongside barriers to care. The impact of these disorders on retention in care, a crucial step of the HIV care continuum, has not been well-studied. We examined the association between these disorders and retention in care over a 2-year period. METHODS Data from January 1, 2011, to June 30, 2019, were obtained from the DC Cohort, an observational HIV study in Washington, District of Columbia. We examined the associations between mental health (i.e., mood-related or trauma-related) or substance use disorders, separately, on not being retained in HIV care over a 2-year interval post-enrollment among non-Hispanic Black women with HIV. Multivariate logistic regression with adjusted odds ratios (aORs) for sociodemographic and clinical variables was used to quantify the association of 1) having a confirmed mental health or substance use disorder and 2) not being retained in care. RESULTS Among the 2,181 women in this analysis, 690 (31.64%) were not retained in care. The prevalence of a mood-related disorder (39.84%) was higher compared with a substance use (16.19%) or trauma-related disorder (7.75%). Age per a 10-year increase (aOR 0.87; confidence interval [CI] 0.80, 0.94) and a mood-related disorder diagnosis (aOR 0.72; CI: 0.59, 0.88) were inversely associated with not being retained in care. CONCLUSION Mood-related disorders were prevalent among Black women with HIV in Washington, District of Columbia, but were not associated with worse retention in care. Future studies should examine key facilitators for Black women with HIV and coexisting mood-related disorders and how they impact retention in care.
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Affiliation(s)
- Bianca Stewart
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
| | - Morgan Byrne
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | | | - Michael A Horberg
- Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland
| | - Anne K Monroe
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Amanda D Castel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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3
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Milburn NG, Hamilton AB, Lopez S, Wyatt GE. Mentoring the next generation of behavioral health scientists to promote health equity. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 89:369-377. [PMID: 31070422 PMCID: PMC7577403 DOI: 10.1037/ort0000415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the life span. To address these problems, our training program, the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), mentors and trains early career behavioral health scientists to conduct research using scientifically sound, culturally collaborative, and population-centered approaches. HA-STTP has been highly successful in training a diverse, productive, nationwide group of scholars. The program provides 2 years of training and mentorship to 20 (5 per year over 4 years) scholars. It is unique in its attention to traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. Furthermore, our training program embraces a uniquely comprehensive, culturally grounded understanding of traumatic stress and its implications for substance abuse and HIV. HA-STTP advances scholars' knowledge of the interconnections among substance abuse, HIV/AIDS, traumatic stress, and health disparities, particularly in underrepresented populations; provides intensive mentorship to support scholars' research interests and career trajectories; capitalizes on a multidisciplinary, multiracial/ethnic network of expert faculty; and evaluates the program's impact on scholars' knowledge and productivity. By fostering the growth of scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this program enhances nationwide efforts to diminish the prevalence of these problems and improve health and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, University of California
| | - Alison B Hamilton
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
| | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, University of California
| | - Gail E Wyatt
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
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The adherence gap: a longitudinal examination of men's and women's antiretroviral therapy adherence in British Columbia, 2000-2014. AIDS 2017; 31:827-833. [PMID: 28272135 DOI: 10.1097/qad.0000000000001408] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to observe the effect of sex on attaining optimal adherence to combination antiretroviral therapy (cART) longitudinally while controlling for known adherence confounders - IDU and ethnicity. DESIGN Using the population-based HAART Observational Medical Evaluation and Research cohort, data were collected from HIV-positive adults, aged at least 19 years, receiving cART in British Columbia, Canada, with data collected between 2000 and 2014. cART adherence was assessed using pharmacy refill data. The proportion of participants reaching optimal (≥95%) adherence by sex was compared per 6-month period from initiation of therapy onward. Generalized linear mixed models with logistic regression examined the effect of sex on cART adherence. RESULTS Among 4534 individuals followed for a median of 65.9 months (interquartile range: 37.0-103.2), 904 (19.9%) were women, 589 (13.0%) were Indigenous, and 1603 (35.4%) had a history of IDU. A significantly lower proportion of women relative to men were optimally adherent overall (57.0 vs. 77.1%; P < 0.001) and in covariate analyses. In adjusted analyses, female sex remained independently associated with suboptimal adherence overall (adjusted odds ratio: 0.55; 95% confidence interval: 0.48-0.63). CONCLUSION Women living with HIV had significantly lower cART adherence rates then men across a 14-year period overall, and by subgroup. Targeted research is required to identify barriers to adherence among women living with HIV to tailor women-centered HIV care and treatment support services.
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Niu L, Qiu Y, Luo D, Chen X, Wang M, Pakenham KI, Zhang X, Huang Z, Xiao S. Cross-Culture Validation of the HIV/AIDS Stress Scale: The Development of a Revised Chinese Version. PLoS One 2016; 11:e0152990. [PMID: 27043134 PMCID: PMC4820124 DOI: 10.1371/journal.pone.0152990] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/22/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Being HIV-infected is a stressful experience for many individuals. To assess HIV-related stress in the Chinese context, a measure with satisfied psychometric properties is yet underdeveloped. This study aimed to examine the psychometric characteristics of a simplified Chinese version of the HIV/AIDS Stress Scale (SS-HIV) among people living with HIV/AIDS in central China. METHOD A total of 667 people living with HIV (92% were male) were recruited from March 1st 2014 to August 31th 2015 by consecutive sampling. A standard questionnaire package containing the Chinese HIV/AIDS Stress Scale (CSS-HIV), the Chinese Patient Health Questionnaire-9 (PHQ-9), and the Chinese Generalized Anxiety Disorder Scale (GAD-7) were administered to all participants, and 38 of the participants were selected randomly to be re-tested in four weeks after the initial testing. RESULTS Our data supported that a revised 17-item CSS-HIV had adequate psychometric properties. It consisted of 3 factors: emotional stress (6 items), social stress (6 items) and instrumental stress (5 items). The overall Cronbach's α was 0.906, and the test-retest reliability coefficient was 0.832. The revised CSS-HIV was significantly correlated with the number of HIV-related symptoms, as well as scores on the PHQ-9 and GAD-7, indicating acceptable concurrent validity. CONCLUSION The 17-item Chinese version of the SS-HIV has potential research and clinical utility in identifying important stressors among the Chinese HIV-infected population and in understanding the effects of stress on adjustment to HIV.
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Affiliation(s)
- Lu Niu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Yangyang Qiu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Luo
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Xi Chen
- Hunan provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Min Wang
- The First Hospital of Changsha, Changsha, Hunan, China
| | | | - Xixing Zhang
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Zhulin Huang
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
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Myers HF, Wyatt GE, Ullman JB, Loeb TB, Chin D, Prause N, Zhang M, Williams JK, Slavich GM, Liu H. Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2015; 7:243-51. [PMID: 25961869 PMCID: PMC4445692 DOI: 10.1037/a0039077] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health.
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Affiliation(s)
- Hector F Myers
- Center for Medicine, Health, & Society and Psychology, Vanderbilt University
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | - Tamra B Loeb
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Nicole Prause
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - John K Williams
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California
| | - Honghu Liu
- School of Dentistry, University of California, Los Angeles
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Lanier L, DeMarco R. A synthesis of the theory of silencing the self and the social ecological model: understanding gender, race, and depression in African American women living with HIV infection. AIDS Patient Care STDS 2015; 29:142-9. [PMID: 25614997 DOI: 10.1089/apc.2014.0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The challenges that face African American women living with HIV are immense. African American women continue to be disproportionately infected and affected by this chronic and life-threatening infection in a complex context of individual experience, interactions with the environment, formal and informal support systems, and cultural belief systems. This article identifies the Theory of Silencing the Self (STS) and a widely known model, the Social Ecological Model (SEM), as a synthesized explanatory framework in helping nurses understand how to address research questions and clinical care that is congruent with the experience of African American women living with HIV infection. In synthesizing the components of these two frameworks, an explanation of the relationship between disempowerment and depression in this population will be uncovered as a key component to making relationships at the individual, family, and community level better. Helping African American women living with HIV infection to explore and address how choosing to be silent across their life systems will advance healthcare adherence as we currently know it to improved self-management of a chronic, gender-specific, culturally-bound experience of depression.
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Affiliation(s)
- Latrona Lanier
- Department of Nursing, Darton State College, Albany, Georgia
| | - Rosanna DeMarco
- Department of Nursing, College of Nursing and Health Sciences, University Massachusetts Boston, Boston, Massachusetts
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DeMarco RF, Chan K. The Sistah Powah Structured Writing Intervention: A Feasibility Study for Aging, Low-Income, HIV-Positive Black Women. Am J Health Promot 2013; 28:108-18. [DOI: 10.4278/ajhp.120227-quan-115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. The purpose of this study was to test the feasibility and assess outcomes of health care adherence based on whether participants engage in particular risky behaviors relevant to general health or living with human immunodeficiency virus (HIV) infection and the frequency of these adherent behaviors. Health adherent behaviors include both self-advocacy and decreased stigma as underlying key components. Design. A randomized control trial comparing peer-led attention control support and intervention groups. Setting. Community-based women's drop-in center in an urban, black neighborhood of Boston, Massachusetts. Subjects. Aging, low-income, black women living with HIV infection. Intervention. Peer-led, small-group, structured writing using film clips from Women's Voices Women's Lives as a writing prompt. Measures. Demographic and outcome data that included adherence, self-advocacy, and stigma; collected at baseline, 6 weeks, and 6 months. Analysis. Repeated-measures analysis of variance scores were examined between groups and waves. Paired-sample t-tests were used to examine mean differences across time. Results. Sample included 110 women (intervention, n = 56; comparison, n = 54). Retention was 85.5%. Repeated-measures analysis indicated intervention group condom use (n = 69, F = 8.02, df = 1, p < .01) and safe sex (n = 71, F = 13.02, df = 1, p < .01) was higher than that of comparison group. A time effect was also found in the Silencing the Self Scale (n = 91, Pillai's trace = 7.21, df = 2, p < .01). Conclusion. This study demonstrates the feasibility of a tailored, peer-led, and culturally relevant interventions and tentative efficacy in populations affected by health disparities. Key limitations include no comparison intervention format with women who can't write and the need to test generalizability.
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Giunta B, Hervey W, Klippel C, Obregon D, Robben D, Hartney K, di Ciccone BL, Fernandez F. Psychiatric Complications of HIV Infection: An Overview. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20130503-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Brumsey AD, Joseph NT, Myers HF, Ullman JB, Wyatt GE. Modeling the Relationship between Trauma and Psychological Distress among HIV-Positive and HIV-Negative Women. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2013; 5:69-76. [PMID: 24587871 DOI: 10.1037/a0022381] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated the association between cumulative exposure to multiple traumatic events and psychological distress, as mediated by problematic substance use and impaired psychosocial resources. A sample of HIV-positive and HIV-negative women were assessed for a history of childhood and adult sexual abuse and non-sexual trauma as predictors of psychological distress (i.e., depression, non-specific anxiety, and posttraumatic stress), as mediated by problematic alcohol and drug use and psychosocial resources (i.e., social support, self-esteem and optimism). Structural equation modeling confirmed that cumulative trauma exposure is positively associated with greater psychological distress, and that this association is partially mediated through impaired psychosocial resources. However, although cumulative trauma was associated with greater problematic substance use, substance use did not mediate the relationship between trauma and psychological distress.
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Affiliation(s)
| | | | - Hector F Myers
- Department of Psychology, University of California, Los Angeles
| | - Jodie B Ullman
- Department of Psychology, California State University, San Bernardino
| | - Gail E Wyatt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience, University of California, Los Angeles
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Childhood sexual abuse severity and disclosure as predictors of depression among adult African-American and Latina women. J Nerv Ment Dis 2011; 199:471-7. [PMID: 21716061 PMCID: PMC3445434 DOI: 10.1097/nmd.0b013e31822142ac] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A history of childhood sexual abuse (CSA) has been associated with adult depression, but data on abuse severity and disclosure are scant, particularly among low-income ethnic minorities. CSA often co-occurs with other adversities, which also increase the risk of depression. This study examined the peritrauma variable of abuse severity and the posttrauma variables of disclosure and self-blame as predictors of current depression symptoms in 94 low-income African-American and Latina women with histories of CSA. After controlling for nonsexual childhood adversity and adult burden (i.e., chronic stress), severe CSA overall was associated with higher depression scores, especially among Latinas who disclosed their abuse. Depression symptoms among African-American women were highest in those who disclosed and reported high levels of self-blame at the time of the incident. The link between depression and specific peri- and post-CSA factors in minority women may help guide future interventions.
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Daniulaityte R, Carlson RG. "To Numb Out and Start to Feel Nothing": Experiences of Stress Among Crack-Cocaine Using Women in a Midwestern City. JOURNAL OF DRUG ISSUES 2011; 41:1-24. [PMID: 21625334 DOI: 10.1177/002204261104100101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study uses qualitative interviews conducted with 19 crack using women to explore their experiences of stress and their views regarding the relationship between stress and drug use. Fifteen of the women participated in follow-up interviews conducted 5-7 years after the baseline. Life history interviews unveiled a pattern of close connection between the intensity of women's drug use and the level of stress they experienced in relation to their past adversities and current life circumstances. The majority of the women viewed stress as an important causal explanation of their drug use. Tensions related to romantic relationships, traumatic childhood, motherhood failures, unabated grief, and humiliating experiences of "crack life" were discussed as the most common sources of psychosocial stress. Most women had very limited positive coping resources and skills. Crack use was perceived as a very common, although highly maladaptive, way to deal with stress. Implications for interventions are discussed.
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Abstract
This study reports the prevalence of child (CSA) and adult (ASA) sexual abuse among 535 African American HIV serodiscordant couples from four major United State cities, and its relationship to personal and couple related vulnerabilities and HIV risk factors. As part of a randomized, clinical trial, CSA and ASA histories were obtained through face-to-face interviews. Results indicate that HIV positive women were significantly more likely to report one kind of abuse (32.32%), either before or since age 18 or both (32.6%). HIV-positive men (34.9%) were significantly more likely to report CSA than HIV-negative men (22.0%). Overall, 72% of couples reported that one or both had CSA histories. These findings underscore the heightened emotional vulnerability, and STI and HIV transmission risk taking practices, associated with sexual abuse. Sexual abuse histories among couples should be assessed to better understand how these histories may contribute to couples dynamics and risk-taking practices.
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Grella CE, Anglin MD. Introduction to the special issue on addiction health services: in memory of Douglas Longshore. J Behav Health Serv Res 2008; 36:131-6. [PMID: 19082737 DOI: 10.1007/s11414-008-9157-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 10/28/2008] [Indexed: 10/21/2022]
Abstract
This is an Introduction to a special issue in memory of Douglas Longshore, a prominent researcher in the field of addiction health services. The findings from the ten papers in this issue are summarized and discussed within the context of Doug's development as a researcher and the core themes from his work. Three core areas are addressed: (1) internal processes related to change among substance abusers, (2) processes related to ethnicity and gender, and (3) treatment effectiveness, particularly regarding interventions to reduce risk of HIV/AIDS among substance abusers. The implications for addiction health services are discussed with regard to the application of these themes to practice.
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Affiliation(s)
- Christine E Grella
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA 90025-7535, USA.
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