1
|
Leat S, Ravi KE, Obenauf C. Living in an Intimate Partner Violence Shelter During a Pandemic: Perspectives from Advocates and Survivors. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:435-454. [PMID: 38284243 DOI: 10.1080/26408066.2024.2308828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
PURPOSE With state-wide quarantine policies during the COVID-19 pandemic like those implemented in the state of Texas, intimate partner violence (IPV) shelter staff were forced to incorporate new safety measures to keep survivors and advocates safe. To understand the impact of these adaptations fully, authors interviewed shelter staff and residents to capture both of their experiences living and working in the same shelter during the height of the coronavirus pandemic (summer 2020) to understand how changes in policy and procedure in shelters impacted survivors and advocates. MATERIALS AND METHODS A qualitative phenomenological design was utilized to collect and analyze data from 10 staff and 10 survivors to develop both a textual and a structural description of participant experiences living in an IPV shelter. RESULTS The current study captured the survivors' and advocates' perspectives related to the 1) vacillating views of shelter social distancing and quarantine policies, 2) shelter occupancy and staffing unpredictability, 3) the broader challenges related to environmental stressors and 4) mobility challenges. DISCUSSION Results of this study highlight factors related to interpersonal relationships within the shelter and structural factors of shelter which contributed to stress for participants. CONCLUSION The coronavirus is continuing to present challenges for shelters. Implications can be drawn from provider and client experiences that can inform policies and procedures for future health crises, including the need to mitigate environmental stress and transportation challenges, as well as considerations for maintaining social support should social distancing be necessary in future epidemics.
Collapse
Affiliation(s)
- Sarah Leat
- Social Work, The University of Memphis, Memphis, USA
| | - Kristen E Ravi
- Psychology, The University of Tennessee-Knoxville, Knoxville, USA
| | - Caterina Obenauf
- Psychology, The University of Tennessee-Knoxville, Knoxville, USA
| |
Collapse
|
2
|
Anderson KM, Blumenthal J, Jain S, Sun X, Amico KR, Landovitz R, Zachek CM, Morris S, Moore DJ, Stockman JK. The impact of intimate partner violence on PrEP adherence among U.S. Cisgender women at risk for HIV. BMC Public Health 2024; 24:1461. [PMID: 38822300 PMCID: PMC11140862 DOI: 10.1186/s12889-024-18946-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Cisgender women account for 1 in 5 new HIV infections in the United States, yet remain under-engaged in HIV prevention. Women experiencing violence face risk for HIV due to biological and behavioral mechanisms, and barriers to prevention, such as challenges to Pre-Exposure Prophylaxis for HIV Prevention (PrEP) adherence. In this analysis, we aim to characterize intimate partner violence (IPV) among cisgender heterosexual women enrolled in a PrEP demonstration project and assess the associations with PrEP adherence. METHODS Adherence Enhancement Guided by Individualized Texting and Drug Levels (AEGiS) was a 48-week single-arm open-label study of PrEP adherence in HIV-negative cisgender women in Southern California (N = 130) offered daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). From 6/2016 to 10/2018, women completed a survey reporting HIV risk behavior and experiences of any IPV (past 90-days) and IPV sub-types (past-year, lifetime) and biological testing for HIV/STIs at baseline, and concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots at weeks 4, 12, 24, 36, and 48. Outcomes were TFV-DP concentrations consistent with ≥ 4 or ≥ 6 doses/week at one or multiple visits. Multivariable logistic regression models were conducted to examine associations. RESULTS Past-90-day IPV was reported by 34.4% of participants, and past-year and lifetime subtypes reported by 11.5-41.5%, and 21.5-52.3%, respectively. Women who engaged in sex work and Black women were significantly more likely to report IPV than others. Lifetime physical IPV was negatively associated with adherence at ≥ 4 doses/week at ≥ 3 of 5 visits, while other relationships with any IPV and IPV sub-types were variable. CONCLUSION IPV is an indication for PrEP and important indicator of HIV risk; our findings suggest that physical IPV may also negatively impact long-term PrEP adherence. CLINICAL TRIALS REGISTRATION NCT02584140 (ClinicalTrials.gov), registered 15/10/2015.
Collapse
Grants
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- EI11-SD-005B California HIV/AIDS Research Program
- KL2TR001444 NIH HHS
- P30AI036214 Center for AIDS Research, University of California, San Diego
- P30AI036214 Center for AIDS Research, University of California, San Diego
- P30AI036214 Center for AIDS Research, University of California, San Diego
- P30AI036214 Center for AIDS Research, University of California, San Diego
- P30AI036214 Center for AIDS Research, University of California, San Diego
- National Institutes of Health
Collapse
Affiliation(s)
- Katherine M Anderson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0507, USA.
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Jill Blumenthal
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0507, USA
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0725, USA
| | - Xiaoying Sun
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0725, USA
| | - K Rivet Amico
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Raphael Landovitz
- David Geffen School of Medicine, UCLA Center for Clinical AIDS Research & Education, University of California Los Angeles, Los Angeles, CA, 90024, USA
| | - Christine M Zachek
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego Health, 9300 Campus Point Drive, La Jolla, San Diego, CA, 92037, USA
| | - Sheldon Morris
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0507, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093-0507, USA
| |
Collapse
|
3
|
St Vil NM, Haley DF, Montgomery B, Williams M, Watson L, Zhang S, Wingood GM. An Exploration of Geographic Access to Substance Use Treatment Programs and Violence Against Women. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241246000. [PMID: 38605583 DOI: 10.1177/08862605241246000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Violence against women (VAW) is a significant public health and human rights issue, with an estimated 736 million women globally experiencing VAW. Consistent evidence demonstrates that substance use is associated with VAW and that participation in substance use treatment programs is associated with reduction in substance use-related violence. While evidence demonstrates the ability to address VAW through substance use treatment programs, less attention has been paid to geographic access to substance use programs. If these programs are geographically inaccessible, particularly to marginalized populations, many people will not get the help they need. This study seeks to explore the relationship between geographic access to substance use treatment programs on VAW. Using data from the HIV Prevention Trials Network (HPTN) 064 study, longitudinal multilevel models were used to assess the relationship between neighborhood-level social determinants, with a specific focus on geographic access to Substance Abuse and Mental Health Services Administration (SAMHSA) certified drug and alcohol treatment programs and VAW. The study included 1910 women, ages 18 to 44, living in select geographic areas with high-ranked prevalence of HIV and poverty. The findings of this study indicate that among women who reside in census tracts with high prevalence rates of HIV: (1) substance use increases VAW; (2) VAW decreases as geographic access to SAMHSA-certified drug and alcohol treatment facilities increases; and (3) when looking at specific types of VAW, emotional and physical abuse decreases as geographic access to substance use treatment increases. Policies and programs to increase access to substance use treatment should be explored and evaluated, and more programs are needed that address the intersectionality of substance use and VAW.
Collapse
Affiliation(s)
| | | | | | | | | | - Shuaiqi Zhang
- Statistical Center for HIV/AIDS Research and Prevention, Seattle, WA, USA
| | - Gina M Wingood
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
| |
Collapse
|
4
|
Waterman EA, McLain M, Zulfiqar H, Ahmar Qadeer T, Ciavoi SM. The Link Between Intimate Partner Violence and Food Insecurity: A Review of Quantitative and Qualitative Studies. TRAUMA, VIOLENCE & ABUSE 2024; 25:1511-1530. [PMID: 37485673 DOI: 10.1177/15248380231186152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Intimate partner violence (IPV) and food insecurity are global health issues that affect millions of people worldwide. Numerous studies show that IPV and food insecurity are linked; however, there is a lack of synthesis of this research. Using a systematic search and review, we examined the international quantitative and qualitative research published on the link between IPV and food insecurity. We searched for peer-reviewed, English-language articles with participants above the age of 16 in 4 large online databases. Fifty-six studies were included from around the world that discussed the link between food insecurity and IPV perpetration and/or victimization. We found evidence in both qualitative and quantitative studies for a meaningful connection between these two global health isues. We also reviewed the literature on moderators and mediators (e.g., mental health). Our findings indicate the importance of implementing IPV prevention strategies which also address household food insecurity, and the potential for food insecurity resources to provide IPV resources. Future research should focus more frequently on IPV perpetration as opposed to victimization, and further examine the moderating and mediating mechanisms that inform the link between IPV and food insecurity.
Collapse
|
5
|
Bruffaerts R, Axinn WG. Associations Between Forced Intercourse and Subsequent Depression Among Women in the U.S. General Population. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:471-480. [PMID: 38158510 PMCID: PMC10872405 DOI: 10.1007/s10508-023-02774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N = 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental physical abuse or parental violence). Women who experienced childhood depression (prevalence: 15%) had 2.57 times the odds of experiencing forced intercourse after depression onset, even after adjusting for these other risk factors. However, even though childhood depression is a powerful risk factor for later MDE, independent of that women who experienced forced intercourse had 2.28 times the odds of experiencing MDE after the occurrence of forced intercourse, adjusting for childhood depression and other risk factors. This study provided the first clear evidence for time-ordered associations between forced intercourse and subsequent MDE among women in the general population.
Collapse
Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum-KU Leuven, Leuven, Belgium
| | - William G Axinn
- Institute for Social Research, University of Michigan, 426 Thompson St., PO Box 1248, Ann Arbor, MI, 48106-1248, USA.
| |
Collapse
|
6
|
Palar K, Sheira LA, Frongillo EA, Kushel M, Wilson TE, Conroy AA, Adedimeji A, Merenstein D, Cohen MH, Wentz EL, Adimora AA, Ofotokun I, Metsch LR, Turan JM, Tien PC, Weiser SD. Longitudinal Relationship Between Food Insecurity, Engagement in Care, and ART Adherence Among US Women Living with HIV. AIDS Behav 2023; 27:3345-3355. [PMID: 37067613 PMCID: PMC10783960 DOI: 10.1007/s10461-023-04053-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/18/2023]
Abstract
Food insecurity disproportionately affects people with HIV and women in the United States (US). More evidence is needed to understand the interplay between levels of food insecurity and levels of antiretroviral therapy (ART) adherence over time, as well as how food insecurity relates to engagement in HIV care. We used random effects models with longitudinal data from the US Women's Interagency HIV Study to estimate the (1) adjusted associations of current and 6-month lagged food security with ART adherence categories (n = 1646), and (2) adjusted associations of food security with engagement-in-care (n = 1733). Very low food security was associated with a higher relative risk of ART non-adherence at prior and current visits compared with food security, and this association increased across non-adherence categories. Very low food security was associated with lower odds of receiving HIV care and higher odds of a missed visit. Food insecurity among US women with HIV is associated with poorer engagement in care and degree of ART non-adherence over time.
Collapse
Affiliation(s)
- Kartika Palar
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Lila A Sheira
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Margot Kushel
- Division of General Internal Medicine at San Francisco General Hospital, UCSF, San Francisco, CA, USA
| | - Tracey E Wilson
- Department of Community Health Sciences, State University of New York Downstate Health Sciences University, School of Public Health, Brooklyn, NY, USA
| | - Amy A Conroy
- Department of Medicine, Center for AIDS Prevention Studies, UCSF, San Francisco, CA, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniel Merenstein
- Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Mardge H Cohen
- Department of Medicine, Stroger Hospital, Chicago, IL, USA
| | - Eryka L Wentz
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Adaora A Adimora
- School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ighovwerha Ofotokun
- School of Medicine, Emory University, Atlanta, GA, USA
- Grady Healthcare System, Atlanta, GA, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Janet M Turan
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Phyllis C Tien
- Department of Medicine, University of California, San Francisco, CA, USA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, USA
| | - Sheri D Weiser
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Center for AIDS Prevention Studies, UCSF, San Francisco, CA, USA
| |
Collapse
|
7
|
Fedina L, Shyrokonis Y, Backes B, Schultz K, Ashwell L, Hafner S, Rosay A. Intimate Partner Violence, Economic Insecurity, and Health Outcomes Among American Indian and Alaska Native Men and Women: Findings From a National Sample. Violence Against Women 2023; 29:2060-2079. [PMID: 36168282 DOI: 10.1177/10778012221127725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Limited data are available on experiences of intimate partner violence (IPV) and sexual violence (SV) and health outcomes among American Indian and Alaska Native (AIAN) populations. This study explores the relationship between IPV and SV, food insecurity, housing insecurity, healthcare access, and self-reported physical and mental health status in a nationally representative sample of AIAN adults (N = 3,634). IPV and SV were associated with poorer physical and mental health at the bivariate level, but not in multivariate analyses. Economic inequalities are a salient predictor of health and may be compounded by demographic and geographic contexts.
Collapse
Affiliation(s)
- Lisa Fedina
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | - Bethany Backes
- Department of Criminal Justice and School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Katie Schultz
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Louise Ashwell
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Steven Hafner
- Center for Human Identification at the University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Andre Rosay
- College of Health, University of Alaska Anchorage, Anchorage, AK, USA
| |
Collapse
|
8
|
Conroy AA, Tebbetts S, Darbes LA, Hahn JA, Neilands TB, McKenna SA, Mulauzi N, Mkandawire J, Ssewamala FM. Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi. AIDS Behav 2023; 27:2255-2270. [PMID: 36520335 PMCID: PMC9753077 DOI: 10.1007/s10461-022-03956-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Heavy alcohol use among people with HIV in sub-Saharan Africa is driven by household economics such as poverty and unemployment and has negative impacts on couple relationships. Multilevel interventions have the potential to reduce alcohol use and improve relationship outcomes by addressing the web of co-occurring economic, social, and dyadic factors. This objective of this study was to develop an economic and relationship-strengthening intervention for couples in Malawi, consisting of matched savings accounts with financial literacy training and a couples counseling component to build relationship skills. Informed by the ADAPT-ITT framework, we collected multiple rounds of focus group data with key stakeholders and couples to gain input on the concept, session content, and procedures, held team meetings with field staff and an international team of researchers to tailor the intervention to couples in Malawi, and refined the intervention manual and components. The results describe a rigorous adaptation process based on the eight steps of ADAPT-ITT, insights gained from formative data and modifications made, and a description of the final intervention to be evaluated in a pilot randomized clinical trial. The economic and relationship-strengthening intervention shows great promise of being feasible, acceptable, and efficacious for couples affected by HIV and heavy alcohol use in Malawi.
Collapse
Affiliation(s)
- Amy A Conroy
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA.
| | - Scott Tebbetts
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA
| | - Lynae A Darbes
- Department of Health Behavior and Biological Sciences, Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Judith A Hahn
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA
| | | | | | - James Mkandawire
- Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA
| | | |
Collapse
|
9
|
Fedina L, Ashwell L, Bright C, Backes B, Newman M, Hafner S, Rosay AB. Racial and Gender Inequalities in Food, Housing, and Healthcare Insecurity Associated with Intimate Partner and Sexual Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23202-NP23221. [PMID: 35404722 DOI: 10.1177/08862605221077231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The costs and consequences of intimate partner violence (IPV) and sexual violence (SV) are well-documented; however, little is known about how experiences of violence are connected to specific economic insecurities including food, healthcare, and housing insecurity among both men and women. This study investigates (1) the prevalence of food, healthcare, and housing insecurity across gender and racial groups exposed to IPV and SV and (2) associations between exposure to past-year IPV and SV and past-year food, healthcare, and housing insecurity controlling for confounding factors. A cross-sectional survey design was used in this study. Data from 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were analyzed in a nationally representative sample of men (N = 8079) and women (N = 9970). Logistic regressions were used to model associations between past-year intimate partner and sexual violence and dependent variables of food, healthcare, and housing insecurity. Analyses were stratified by gender and included control variables of age, income, education, and race/ethnicity. Higher rates of food, housing, and healthcare insecurity were found among men and women of color exposed to violence, particularly among respondents who identified as Black/African American, Latinx, American Indian/Alaska Native, and other racial/ethnic minority groups. For men, IPV and SV was associated with higher odds for experiencing food (AOR = 2.40, p <.001), housing (AOR = 2.06, p <.001), and healthcare insecurity (AOR = 2.39, p <.001). For women, IPV and SV was also associated with higher odds for experiencing food (AOR = 2.16, p <.001), housing (AOR = 1.94, p <.001), and healthcare insecurity (AOR = 2.38, p <.001). Findings identify specific economic needs among survivors and suggest that the burdens of IPV and SV are not equitably shared across racial/ethnic populations. Findings can inform policy that aims to reduce inequalities in food, housing, and healthcare associated with IPV and SV.
Collapse
Affiliation(s)
- Lisa Fedina
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| | - Louise Ashwell
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| | - Charlotte Bright
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Bethany Backes
- School of Social Work and Department of Criminal Justice, University of Central Florida, Orlando, FL, USA
| | - Madeleine Newman
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| | - Steven Hafner
- Center for Human Identification, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Andre B Rosay
- University of Alaska College of Health, Anchorage, AK, USA
| |
Collapse
|
10
|
Luciano TV, Cislaghi B, Miranda RB, Dias JA, Diaz-Bermudez XP, Miranda AE. Violence in Quilombola women living in rural communities in Brazil. Rev Saude Publica 2022; 56:114. [PMID: 36629705 PMCID: PMC9749653 DOI: 10.11606/s1518-8787.2022056004651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/02/2022] [Indexed: 12/28/2022] Open
Abstract
OBJETIVE To estimate the prevalence of psychological, physical, and sexual violence perpetrated against women by their intimate partner (IP) in Quilombola communities located in Espírito Santo State, Brazil. METHODS The data is from a population-based cross-sectional study of Quilombola women conducted from 2017 to 2018. In-person interviews collected information on women's sociodemographic characteristics, behaviors, and their experience of violence perpetrated by their IP. The analysis used chi-square test and hierarchical logistic regression. RESULTS 219 women (94.8% of the invited ones) agreed to participate in the study. 59.0% (95%CI: 5.25-65.5) reported psychological violence; 41% (95%CI: 34.5-47.5) physical violence; and 8.2% (95%CI: 4.6-11.8) sexual violence. Psychological violence was associated with having three or more sexual partners in life, when compared to those who had up to two partners (p = 0,009), and previous violence involving other people outside of family increased the chance of suffering psychological violence by an IP more than nine times (p ≤ 0.001). Regarding physical violence, the association with use of barrier contraception (p = 0.031) and having a partner with other sexual partners (p = 0.024) were protective factors for IP violence. Having 3 or more sexual partners in the last 12 months (p = 0.006), partner using illicit drugs (p = 0,006), and alcoholism in the family (p = 0,001), increased the chance of suffer physical violence by the partner. Sexual violence perpetrated by the IP was associated with miscarriage (p = 0.016), partner using drugs (p = 0.020), and gynecological symptoms (p = 0.045). CONCLUSIONS These results showed the high frequency of intimate partner violence in Quilombola women and highlight the importance of reducing social and race inequities for interrupting the culture of violence against women.
Collapse
Affiliation(s)
- Thaís Verly Luciano
- Universidade Federal do Espírito SantoCentro de Ciências da SaúdePrograma de Pós-Graduação em Saúde ColetivaVitóriaESBrasil Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil
| | - Beniamino Cislaghi
- London School of Hygiene and Tropical MedicineLondonUnited KingdomLondon School of Hygiene and Tropical Medicine. London, United Kingdom
| | - Raquel Barbosa Miranda
- Universidade de BrasíliaFaculdade de Ciências da SaúdePrograma de Pós-Graduação em Saúde ColetivaBrasíliaDFBrasilUniversidade de Brasília. Faculdade de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Brasília, DF, Brasil
| | - Jerusa Araújo Dias
- Universidade Federal do Espírito SantoCentro de Ciências da SaúdePrograma de Pós-Graduação em Saúde ColetivaVitóriaESBrasil Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil
| | - Ximena Pamela Diaz-Bermudez
- Universidade de BrasíliaFaculdade de Ciências da SaúdePrograma de Pós-Graduação em Saúde ColetivaBrasíliaDFBrasilUniversidade de Brasília. Faculdade de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Brasília, DF, Brasil
| | - Angelica Espinosa Miranda
- Universidade Federal do Espírito SantoCentro de Ciências da SaúdePrograma de Pós-Graduação em Saúde ColetivaVitóriaESBrasil Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil
| |
Collapse
|
11
|
Ulutaş Ü, Uçar T. The relationship between domestic violence against women, adaptation to pregnancy and maternal-fetal antenatal attachment. Perspect Psychiatr Care 2022; 58:1433-1441. [PMID: 34541687 DOI: 10.1111/ppc.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/28/2021] [Accepted: 09/05/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to determine the relationship between domestic violence against women, adaptation to pregnancy, and maternal-fetal antenatal attachment. DESIGN AND METHODS The study consisted of 385 pregnant women who were referred to the antenatal clinics of a public hospital in eastern Turkey. The data were collected using the Domestic Violence against Women Scale (DVAWS), the Maternal-Fetal Antenatal Attachment Scale (MAAS), and the Prenatal Self-Evaluation Questionnaire (PSEQ) to assess adaptation to pregnancy. FINDINGS Pregnant women were exposed to low level of violence (Mean ± SD: 64.42 ± 5.30). A statistically significant positive correlation was found between their DVAWS and PSEQ mean scores. There was also a statistically significant positive correlation between their DVAWS and MAAS mean scores. PRACTICE IMPLICATIONS Findings show that as domestic violence against women increased, adaptation to pregnancy decreased and maternal-fetal attachment increased.
Collapse
Affiliation(s)
| | - Tuba Uçar
- Department of Midwifery, İnönü University, Malatya, Turkey
| |
Collapse
|
12
|
Vil NMS, Sperlich M, Fitzpatrick J, Bascug E, Elliott J. "I Thought It Was Normal:" Perspectives of Black Nursing Students From High-Risk IPV Communities on Causes and Solutions to IPV in the Black Community. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12260-NP12283. [PMID: 33685276 DOI: 10.1177/0886260521997939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Black individuals are at high risk for intimate partner violence (IPV) but are less likely to utilize existing IPV services and supports. In an effort toward developing more culturally responsive IPV solutions for the Black community, researchers set out to understand how residents of high-risk IPV communities explained the high rates of IPV in their community, and what they thought possible solutions would entail. A purposive sample of 22 Black nursing students (20 female, 2 male) from a high-IPV risk predominately Black community in Western New York who were students enrolled in a Licensed Practitioner Nursing (LPN) program attended four focus groups that utilized a semi-structured interview format. Their verbatim responses were analyzed using qualitative inductive thematic analysis. Participants identified five major causes of IPV in Black communities: (a) weakened family structure, (b) IPV is normalized (c) community lacks IPV knowledge, (d) mistrust of formal resources, and (e) mental health. They also identified 10 solutions to IPV in Black communities: (a) counseling, (b) peer support groups, (c) use of technology, (d) resources to create self-sufficiency, (e) education, (f) culturally specific resources, (g) reduce stigma, (h) public service announcements, (i) substance abuse treatment, and (j) IPV screenings. Research and clinical implications of the research are discussed, including how these might inform the creation of culturally responsive interventions.
Collapse
Affiliation(s)
- Noelle M St Vil
- University at Buffalo, The State University of New York, USA
| | - Mickey Sperlich
- University at Buffalo, The State University of New York, USA
| | | | - Erin Bascug
- University at Buffalo, The State University of New York, USA
| | | |
Collapse
|
13
|
Chang X, Yang Y, Li R. The characteristics of husbands and violence against women in Wuhan, China: a cross-sectional study. BMC Womens Health 2022; 22:73. [PMID: 35287639 PMCID: PMC8922799 DOI: 10.1186/s12905-022-01650-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Objective To explore the prevalence and correlation between husbands and lifetime domestic violence (DV) among women in Wuhan, China. Methods A cross-sectional study was conducted in a community health center in Wuhan from June 2015 to December 2015. A total of 1015 women who came to the center for gynecological examination were selected through a random sampling. They were assessed using the WHO Violence Against Women Instrument to evaluate the prevalence of DV. The chi-square test, the Wilcoxon rank test, and unadjusted and adjusted logistic regression analyses were used to analyze the possible risk or protective factors for DV. Results The lifetime prevalence of DV was 29.36% (298/1015). The risk factors included heavy physical labor (OR 3.54, 95% CI 1.63–7.77), long-term drinking (OR 1.60, 95% CI 1.19–2.14), overweight or obesity (OR 1.36, 95% CI 1.01–1.88) and long-term smoking (OR 1.03, 95% CI 1.01–1.04). Higher education was a protective factor (OR 0.80, 95% CI 0.66–0.96). Conclusion Women whose husbands had lower education, performed heavy physical labor, were long-term alcohol consumers, had overweight or obesity, and were long-term smokers were vulnerable to lifetime DV.
Collapse
Affiliation(s)
- Xuening Chang
- Child Health Section, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Yifan Yang
- Child Health Section, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Ruizhen Li
- Child Health Section, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China.
| |
Collapse
|
14
|
Jahanfar S, Ahmadpour P, Mirghafourvand M. Forced sex and its predictors among students attending university: a cross-sectional study. Arch Public Health 2022; 80:56. [PMID: 35177118 PMCID: PMC8851864 DOI: 10.1186/s13690-022-00823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Forced sex is associated with negative psychological health outcomes. This study aimed to determine the prevalence of forced sex and its predictors. METHODS This cross-sectional study was performed on 800 students of a university in USA using a random sampling method. Reproductive health electronic questionnaire was used for data collection. Due to the sensitive nature of the questionnaires and for anonymity, Qualtrics software was used. To estimate the extent of the effect of each of the independent variables (knowledge, attitude, as well as socio-demographic characteristics) on the dependent variable (forced sex), multivariate logistic regression was used. RESULTS About one-fifth of students (16.9%) had experienced forced sex. The variables of gender, knowledge about sexually transmitted diseases (STD), and sexual attitude were among the predictors of forced sex. This kind of sexual relationship was more likely to occur in girls than in boys (OR = 2.94, 95%CI: 1.20 to 1.71). Further, the chance of forced sex significantly increased with growing knowledge of STD (OR = 1.41, 95%CI: 1.61 to 1.71), and sexual attitude (OR = 1.23, 95%CI: 1.04 to 1.21). CONCLUSION Considering the impact of gender, knowledge about STD, and sexual attitude on forced sex, educational interventions among the youth especially girls are required to provide complete and proper information about sexual and reproductive health and rights and correct the sexual attitudes of the youth.
Collapse
Affiliation(s)
- Shayesteh Jahanfar
- MPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, USA
| | - Parivash Ahmadpour
- Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
15
|
Leddy AM, Zakaras JM, Shieh J, Conroy AA, Ofotokun I, Tien PC, Weiser SD. Intersections of food insecurity, violence, poor mental health and substance use among US women living with and at risk for HIV: Evidence of a syndemic in need of attention. PLoS One 2021; 16:e0252338. [PMID: 34038490 PMCID: PMC8153505 DOI: 10.1371/journal.pone.0252338] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Food insecurity and intimate partner violence (IPV) are associated with suboptimal HIV prevention and treatment outcomes, yet limited research has explored how food insecurity and IPV intersect to influence HIV-related behaviors. To fill this gap, we conducted a qualitative study with women living with or at risk for HIV in the United States. Methods We conducted 24 in-depth interviews with women enrolled in the San Francisco and Atlanta sites of the Women’s Interagency HIV study (WIHS). Participants were purposively sampled so half were living with HIV and all reported food insecurity and IPV in the past year. Semi-structured interviews explored experiences with food insecurity and IPV, how these experiences might be related and influence HIV risk and treatment behaviors. Analysis was guided by an inductive-deductive approach. Results A predominant theme centered on how food insecurity and IPV co-occur with poor mental health and substance use to influence HIV-related behaviors. Women described how intersecting experiences of food insecurity and IPV negatively affected their mental health, with many indicating using substances to “feel no pain”. Substance use, in turn, was described to perpetuate food insecurity, IPV, and poor mental health in a vicious cycle, ultimately facilitating HIV risk behaviors and preventing HIV treatment adherence. Conclusions Food insecurity, IPV, poor mental health and substance use intersect and negatively influence HIV prevention and treatment behaviors. Findings offer preliminary evidence of a syndemic that goes beyond the more widely studied “SAVA” (substance use, AIDS, and violence) syndemic, drawing attention to additional constructs of mental health and food insecurity. Quantitative research must further characterize the extent and size of this syndemic. Policies that address the social and structural drivers of this syndemic, including multi-level and trauma-informed approaches, should be implemented and evaluated to assess their impact on this syndemic and its negative health effects.
Collapse
Affiliation(s)
- Anna M Leddy
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Jennifer M Zakaras
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Jacqueline Shieh
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Amy A Conroy
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Ighovwerha Ofotokun
- School of Medicine, Emory University and Grady Healthcare System, Atlanta, GA, United States of America
| | - Phyllis C Tien
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America.,Department of Veteran Affairs Medical Center, San Francisco, CA, United States of America
| | - Sheri D Weiser
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| |
Collapse
|
16
|
Aizpurua E, Copp J, Ricarte JJ, Vázquez D. Controlling Behaviors and Intimate Partner Violence Among Women in Spain: An Examination of Individual, Partner, and Relationship Risk Factors for Physical and Psychological Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:231-254. [PMID: 29294888 DOI: 10.1177/0886260517723744] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intimate partner violence (IPV) has been linked to a broad range of negative consequences. Thus, early detection and prevention of behaviors associated with IPV is necessary to combat this global public health problem. Controlling behaviors (CBs) within the intimate context, including acts to constrain free mobility or access to friends and relatives, have been characterized as a moderate form of violence and may be an indicator of more severe IPV. Previous research in this field, however, has been primarily conducted in the United States. Accordingly, we lack knowledge of similar findings in other countries to draw more general conclusions about observed associations between these variables, and to identify underlying mechanisms. The current study analyzes the role of control within the Spanish context by examining its correlates, as well as the role and impact of CBs on psychological and physical violence. To achieve these objectives, we use data from the Spanish sample of the Violence Against Women Survey carried out by the European Union Agency for Fundamental Rights (N = 1,520 adult women). The results indicated that young women, women with a previous history of physical/sexual abuse during childhood, and women who have resided in Spain for fewer years are at greater risk of experiencing control within the context of an ongoing relationship. Partner risk factors included frequent episodes of drunkenness and general violence (i.e., violence outside of the home). In addition, control was more frequently reported among couples where the man was older than the woman. As hypothesized, women who reported CB by their partners were more likely to experience psychological and physical violence. These findings emphasize the importance of preventing CBs to avert the most severe forms of violence, and provides relevant information about the groups that could most benefit from these efforts.
Collapse
|
17
|
Caiola C, McCoy TP, Kneipp SM. Modeling upstream socioeconomic inequities and syndemic conditions among mothers over time. Public Health Nurs 2020; 38:186-196. [PMID: 33155326 DOI: 10.1111/phn.12831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Mothers in lower social locations are particularly vulnerable to the syndemic conditions of substance abuse, violence, and HIV/AIDS (SAVA), yet few studies have examined the impact of upstream socioeconomic inequities as salient determinants of syndemic conditions in their lives. The purpose of this study was to investigate the influence of Temporary Assistance for Needy Families (TANF) receipt, TANF sanctions, and economic hardship (EH) on SAVA syndemic conditions that included indicators of substance use, HIV risk-taking behaviors, and intimate partner violence among mothers over time. METHODS Using data from the Fragile Families and Child Wellbeing Study (n = 4,898), we investigated the longitudinal measurement invariance of a proposed measure of syndemic conditions among mothers over five waves and performed path analysis to investigate the relationships between TANF use, TANF sanctions, and EH with syndemic conditions. RESULTS Analyses revealed the presence of SAVA syndemic conditions and EH predicted increased SAVA in subsequent waves. Relationships between reported race of the mother and the sanctioning of TANF benefits and increased SAVA were also noted. CONCLUSIONS This study has implications regarding race, welfare policy and sanctioning practices, and the socioeconomic determinants of health that drive syndemic conditions among mothers in the United States.
Collapse
Affiliation(s)
- Courtney Caiola
- College of Nursing, East Carolina University, Greenville, NC, USA
| | - Thomas P McCoy
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Shawn M Kneipp
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
18
|
Hemphill JC. A Qualitative Exploration of Perspectives of Strength among Trauma-Exposed Women Living within Homelessness. Issues Ment Health Nurs 2020; 41:773-784. [PMID: 32497456 DOI: 10.1080/01612840.2020.1742257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to facilitate self-discovery of strengths of women who were homeless and trauma-exposed. Using an emancipatory feminist and existential phenomenological qualitative research design, seventeen women participated in facilitative dialogs exploring perceptions of strength. The dialogue focused on three aspects of strength: characteristics, strategies, and barriers. The participants' words were represented within global themes of strength: balance, protection, and dangerous environments. Results suggest women who are houseless and abused find ways to remain strong as evidenced in their stories. Findings support strength-based discovery, patient engagement, and partnering as a health intervention with vulnerable women.
Collapse
Affiliation(s)
- Jean Croce Hemphill
- Graduate Nursing Programs, East Tennessee State University, Johnson, Tennessee, USA.,University of Tennessee Knoxville, Knoxville, Tennessee, USA
| |
Collapse
|
19
|
|
20
|
Aslan E, Bodur G, Beji NK, Alkan N, Aksoy Ö. Exposure to domestic violence in women living in Istanbul and Aegean regions: a Turkish sample. CIENCIA & SAUDE COLETIVA 2019; 24:2835-2844. [PMID: 31389532 DOI: 10.1590/1413-81232018248.22952017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/27/2017] [Indexed: 11/21/2022] Open
Abstract
Domestic violence (DV) is a serious public health problem in the world. DV against women is also a global problem without cultural, geographic, religious, social, economic or national boundaries. This descriptive cross-sectional study was carried out to determine the situations of DV in women living in Istanbul and the Aegean Region in Turkey. The study population included outpatient clinics of state hospitals both regions. A stratified sampling by age was performed and 1100 women were included into the sample. Data were collected at face-to-face interviews with Domestic Violence Against Women Determination Scale. The mean age of the women living in Istanbul was 41.81 ± 9.75 years and Aegean Region was 33.72 ± 11.38 years. The prevalence of emotional and financial violence were higher in Istanbul and the Aegean Region. The women living in Istanbul got higher scores for Domestic Violence Against Women Determination Scale. The prevalence of the women reporting to suffer from violence from their spouses was 15.4% in Istanbul and 14% in the Aegean Region. While the prevalence of the women suffering from violence was higher in Istanbul, the women in Aegean Region suffered from more severe violence. The violence prevalence was lower among the wives and the husbands with high education levels, employed women and high-income families.
Collapse
Affiliation(s)
- Ergül Aslan
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa. Abide-i Hürriyet Cad. 34381 Şişli Istanbul Turkey.
| | - Gönül Bodur
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa. Abide-i Hürriyet Cad. 34381 Şişli Istanbul Turkey.
| | | | - Nevzat Alkan
- School of Medicine, Istanbul University Istanbul
| | - Ömercan Aksoy
- Institute of Graduate Education, Istanbul University. Cerrahpasa Istanbul Turkey
| |
Collapse
|
21
|
Whittle HJ, Sheira LA, Wolfe WR, Frongillo EA, Palar K, Merenstein D, Wilson TE, Adedimeji A, Weber KM, Adimora AA, Ofotokun I, Metsch L, Turan JM, Wentz EL, Tien PC, Weiser SD. Food insecurity is associated with anxiety, stress, and symptoms of posttraumatic stress disorder in a cohort of women with or at risk of HIV in the United States. J Nutr 2019; 149:1393-1403. [PMID: 31127819 PMCID: PMC6675617 DOI: 10.1093/jn/nxz093] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/19/2019] [Accepted: 04/10/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Food insecurity, which disproportionately affects marginalized women in the United States, is associated with depressive symptoms. Few studies have examined relations of food insecurity with other mental health outcomes. OBJECTIVE The aim of this study was to investigate the associations of food insecurity with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD) in the Women's Interagency HIV Study (WIHS), a prospective cohort study of women with or at risk of HIV in the United States. METHODS Participants were 2553 women with or at risk of HIV, predominantly African American/black (71.6%). Structured questionnaires were conducted during April 2013-March 2016 every 6 mo. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. We measured longitudinal outcomes for GAD (GAD-7 score and a binary GAD-7 screener for moderate-to-severe GAD). Only cross-sectional data were available for outcomes measuring perceived stress (PSS-10 score) and PTSD (PCL-C score and a binary PCL-C screener for PTSD). We examined associations of FS with the outcomes through use of multivariable linear and logistic regression, including lagged associations with GAD outcomes. RESULTS After adjusting for sociodemographic and health-related factors including HIV serostatus, current marginal, low, and very low FS were associated with increasingly higher GAD-7 scores, and with 1.41 (95% CI: 1.10, 1.80; P < 0.01), 2.03 (95% CI: 1.59, 2.61; P < 0.001), and 3.23 (95% CI: 2.43, 4.29; P < 0.001) times higher odds of screening positive for moderate-to-severe GAD, respectively. Low and very low FS at the previous visit (6 mo earlier) were independently associated with GAD outcomes at current visit. Associations of FS with PSS-10 and PCL-C scores exhibited similar dose-response relations. Very low FS was associated with 1.93 (95% CI: 1.15, 3.24; P < 0.05) times higher odds of screening positive for PTSD. CONCLUSIONS Food insecurity may be associated with a range of poor mental health outcomes among women in the United States with or at risk of HIV.
Collapse
Affiliation(s)
- Henry J Whittle
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK,Address correspondence to HJW (e-mail: )
| | | | | | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC
| | | | - Daniel Merenstein
- Department of Family Medicine, Georgetown University Medical Center, Washington, DC
| | - Tracey E Wilson
- Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Kathleen M Weber
- Cook County Health and Hospitals System and Hektoen Institute of Medicine, Chicago, IL
| | - Adaora A Adimora
- School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ighovwerha Ofotokun
- School of Medicine, Emory University, Atlanta, GA, and Grady Healthcare System, Atlanta, GA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Eryka L Wentz
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Phyllis C Tien
- Department of Medicine, UCSF and Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
| | - Sheri D Weiser
- Division of HIV, ID and Global Medicine,Center for AIDS Prevention Studies, UCSF, San Francisco, CA
| |
Collapse
|
22
|
Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the U.S. PLoS One 2019; 14:e0213365. [PMID: 30840700 PMCID: PMC6402690 DOI: 10.1371/journal.pone.0213365] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/20/2019] [Indexed: 11/24/2022] Open
Abstract
Background Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV. Methods Study participants completed six assessments from 2013–16 on food insecurity (operationalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling for visits (level 1) nested within individuals (level 2), to estimate the association of experiencing violence. Results Among 2,343 women (8,528 visits), we found that victims of sexual or physical violence (odds ratio = 3.10; 95% confidence interval: 1.88, 5.19) and psychological violence (odds ratio = 3.00; 95% confidence interval: 1.67, 5.50) were more likely to report very low food security. The odds of experiencing violence were higher for women with very low food security at both the current and previous visit as compared to only the current visit. HIV status did not modify these associations. Conclusions Food insecurity was strongly associated with violence, and women exposed to persistent food insecurity were even more likely to experience violence. Food programs and policy must consider persistent exposure to food insecurity, and interpersonal harms faced by food insecure women, such as violence.
Collapse
|
23
|
Whittle HJ, Sheira LA, Frongillo EA, Palar K, Cohen J, Merenstein D, Wilson TE, Adedimeji A, Cohen MH, Adimora AA, Ofotokun I, Metsch L, Turan JM, Wentz EL, Tien PC, Weiser SD. Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States. Addiction 2019; 114:127-136. [PMID: 30109752 PMCID: PMC6516859 DOI: 10.1111/add.14418] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/20/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. DESIGN Women's Interagency HIV Study (WIHS), a prospective cohort study. SETTING Nine sites across the United States. PARTICIPANTS A total of 2553 women with or at risk for HIV. MEASUREMENTS Semi-annual structured interviews were conducted during April 2013-March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of current and previous FS with the outcomes simultaneously, adjusting for socio-demographic factors, HIV serostatus, physical health and health insurance. FINDINGS Average number of visits was 4.6. At baseline, 71% of participants were HIV-seropositive, 44% reported marginal, low, or very low FS, and 13% were using illicit substances. In adjusted analyses, current low and very low FS were significantly associated with 1.59 [95% confidence interval (CI) = 1.02, 2.46; P = 0.039] and 2.48 (95% CI = 1.52, 4.04; P < 0.001) higher odds of any illicit substance use, compared to high FS, and also with higher odds of cannabis, stimulant and opioid use, exhibiting a consistent dose-response relationship. Marginal, low, and very low FS at the previous visit were associated with 1.66 (95% CI = 1.08, 2.54; P = 0.020), 1.77 (95% CI = 1.14, 2.74; P = 0.011), and 2.28 (95% CI = 1.43, 3.64; P < 0.001) higher odds of current illicit substance use. CONCLUSIONS Food insecurity appears to be longitudinally associated with substance use among US women with or at risk for HIV.
Collapse
Affiliation(s)
| | - Lila A. Sheira
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Educaton, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Kartika Palar
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Jennifer Cohen
- Department of Clinical Pharmacy, UCSF, San Francisco, CA, USA
| | - Daniel Merenstein
- Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Tracey E. Wilson
- Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Adaora A. Adimora
- School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ighovwerha Ofotokun
- School of Medicine, Emory University, Atlanta, GA, USA,Grady Healthcare System, Atlanta, GA, USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Janet M. Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eryka L. Wentz
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Phyllis C. Tien
- Department of Medicine, UCSF and Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA, USA
| | - Sheri D. Weiser
- Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA,Center for AIDS Prevention Studies, UCSF, San Francisco, CA, USA
| |
Collapse
|
24
|
Hellmann DF, Kinninger MW, Kliem S. Sexual Violence against Women in Germany: Prevalence and Risk Markers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081613. [PMID: 30061527 PMCID: PMC6121316 DOI: 10.3390/ijerph15081613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/08/2022]
Abstract
Previous research has repeatedly shown that gender-based violence affects a considerable proportion of women in any given population. Apart from providing current estimates of the prevalence of sexual violence against women in Germany, we identified specific risk markers applying an advanced statistical method. We analyzed data from a survey of N = 4450 women representative of the German population, conducted by the Criminological Research Institute of Lower Saxony in 2011. Lifetime prevalence for experiencing sexual violence was 5.4% for women aged 21–40 years (five-year prevalence: 2.5%). Non-parametric conditional inference tree (C-Tree) analyses revealed that physical and sexual abuse during childhood as well as being divorced, separated, or widowed was the most informative constellation of risk markers, increasing the five-year prevalence rate of experienced sexual violence victimizations up to 17.0%. Furthermore, knowing about the official penalization of marital rape was related to a lower victimization risk for women without a history of parental violence. Possible explanations for these findings as well as implications for future research are critically discussed.
Collapse
Affiliation(s)
- Deborah F Hellmann
- University of Applied Administrative Sciences NRW, 47269 Duisburg, Germany.
| | - Max W Kinninger
- Department of International Public Law and Comparative Law, Albert-Ludwigs-University Freiburg, 79085 Freiburg im Breisgau, Germany.
| | - Sören Kliem
- Criminological Research Institute of Lower Saxony, 30161 Hannover, Germany.
| |
Collapse
|
25
|
Montgomery BEE, Frew PM, Hughes JP, Wang J, Adimora AA, Haley DF, Kuo I, Jennings L, El-Bassel N, Hodder SL. HIV Risk Characteristics Associated with Violence Against Women: A Longitudinal Study Among Women in the United States. J Womens Health (Larchmt) 2018; 27:1317-1326. [PMID: 29905502 DOI: 10.1089/jwh.2017.6505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Using data from HIV Prevention Trials Network 064, a multisite, observational cohort study conducted to estimate HIV incidence rates among women living in areas of high poverty and HIV prevalence in the United States, we examined the use of HIV risk characteristics to predict emotional abuse, physical violence, and forced sex. METHODS Participants included 2099 women, 18-44 years of age, who reported unprotected vaginal or anal sex with a male partner and an additional personal or perceived male partner HIV risk characteristic in the past 6 months. Adjusting for time-varying covariates, generalized estimating equations were used to assess the ability of HIV risk characteristics to predict violence 6 months later. RESULTS Reported analyses were limited to the 1980 study participants who reported having a male sex partner at that assessment. Exchanging sex, perceived partner concurrency, and perceived partner incarceration were significantly predictive of emotional abuse 6 months later (adjusted odds ratio [AOR]: 1.60; 1.59; 1.34, respectively). Prior sexually transmitted infection diagnosis, exchanging sex, and binge drinking were significantly predictive of physical violence 6 months later (AOR: 1.62; 1.71; 1.47, respectively). None of the variables measured was significantly predictive of forced sex. CONCLUSIONS Strategies that address reducing violence against women should be studied further in the context of HIV prevention programs.
Collapse
Affiliation(s)
- Brooke E E Montgomery
- 1 Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock, Arkansas
| | - Paula M Frew
- 2 Department of Medicine, Emory University School of Medicine , Atlanta, Georgia .,3 Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta, Georgia .,4 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University , Atlanta, Georgia
| | - James P Hughes
- 5 Department of Biostatistics, University of Washington , Seattle, Washington
| | - Jing Wang
- 6 Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center , Seattle, Washington
| | - Adaora A Adimora
- 7 UNC School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Danielle F Haley
- 8 Institute for Global Health and Infectious Diseases , School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Irene Kuo
- 9 Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University , Washington, District of Columbia
| | - Larissa Jennings
- 10 Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Nabila El-Bassel
- 11 Columbia University School of Social Work , New York, New York
| | - Sally L Hodder
- 12 West Virginia Clinical and Translational Science Institute , Morgantown, West Virginia
| |
Collapse
|
26
|
Vermund SH, Hamilton EL, Griffith SB, Jennings L, Dyer TV, Mayer K, Wheeler D. Recruitment of Underrepresented Minority Researchers into HIV Prevention Research: The HIV Prevention Trials Network Scholars Program. AIDS Res Hum Retroviruses 2018; 34:171-177. [PMID: 29145745 PMCID: PMC5806068 DOI: 10.1089/aid.2017.0093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Most U.S. investigators in the HIV Prevention Trials Network (HPTN) have been of majority race/ethnicity and sexual orientation. Research participants, in contrast, have been disproportionately from racial/ethnic minorities and men who have sex with men (MSM), reflecting the U.S. epidemic. We initiated and subsequently evaluated the HPTN Scholars Program that mentors early career investigators from underrepresented minority groups. Scholars were affiliated with the HPTN for 12-18 months, mentored by a senior researcher to analyze HPTN study data. Participation in scientific committees, trainings, protocol teams, and advisory groups was facilitated, followed by evaluative exit surveys. Twenty-six trainees have produced 17 peer-reviewed articles to date. Research topics typically explored health disparities and HIV prevention among black and Hispanic MSM and at-risk black women. Most scholars (81% in the first five cohorts) continued HIV research after program completion. Alumni reported program-related career benefits and subsequent funding successes. Their feedback also suggested that we must improve the scholars' abilities to engage new research protocols that are developed within the network. Mentored engagement can nurture the professional development of young researchers from racial/ethnic and sexual minority communities. Minority scientists can benefit from training and mentoring within research consortia, whereas the network research benefits from perspectives of underrepresented minority scientists.
Collapse
Affiliation(s)
- Sten H. Vermund
- Department of Epidemiology of Microbial Diseases, Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut
| | | | | | - Larissa Jennings
- Social and Behavioral Interventions Program, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
| | - Kenneth Mayer
- Fenway Health, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Darrell Wheeler
- School of Social Welfare, University at Albany State University of New York, Albany, New York
| |
Collapse
|
27
|
Mainville CH, Richardson MA, Brady SM, Berger-Greenstein J, Bacic J. HIV Risk, Substance Use, and Personality Characteristics among Adults with History of Serious Mental Illness. Behav Med 2017; 43:165-175. [PMID: 28767014 DOI: 10.1080/08964289.2017.1301874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study examined the relationship between characteristics associated with personality disorders, substance use, and HIV risk among adults with a history of serious mental illness. Participants included 103 adults with antisocial or borderline personality disorder, serious mental illness, and recent HIV risk behavior. The sample was predominately male (64%), diverse (42% African American and 13% Hispanic), and homeless/marginally housed (76%). In order to examine the relationship between personality characteristics and risk we constructed a risk index comprising key symptoms of antisocial and borderline personality disorders, namely; impulsivity, affective instability, and disregard for safety of self/others. Contrary to our primary hypotheses, risk index scores did not predict HIV risk behavior and substance abuse did not mediate this risk. Exploratory analyses did reveal that women engaged in significantly more risk behaviors than their male counterparts and that risk scores were a significant predictor of total sex acts for women but not men. In addition, increased emotional dysregulation was a significant predictor of condomless sex acts for women but not men. Finally, recent alcohol use and increased impulsivity was associated with more condomless oral sex for men and women. These results suggest the relationship among serious mental illness, personality disorder, substance abuse, and gender is complex and merits further study.
Collapse
Affiliation(s)
| | - Mark A Richardson
- a Division of Psychiatry , Boston University School of Medicine.,b Department of Psychological & Brain Sciences , Boston University
| | - Stephen M Brady
- a Division of Psychiatry , Boston University School of Medicine
| | | | - Janine Bacic
- c Department of Public Health , Boston University School of Medicine
| |
Collapse
|
28
|
Chilton M, Knowles M, Bloom SL. The Intergenerational Circumstances of Household Food Insecurity and Adversity. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017; 12:269-297. [PMID: 28503244 PMCID: PMC5399810 DOI: 10.1080/19320248.2016.1146195] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Household food insecurity is linked with exposure to violence and adversity throughout the life course, suggesting its transfer across generations. Using grounded theory, we analyzed semistructured interviews with 31 mothers reporting household food insecurity where participants described major life events and social relationships. Through the lens of multigenerational interactions, 4 themes emerged: (1) hunger and violence across the generations, (2) disclosure to family and friends, (3) depression and problems with emotional management, and (4) breaking out of intergenerational patterns. After describing these themes and how they relate to reports of food insecurity, we identify opportunities for social services and policy intervention.
Collapse
Affiliation(s)
- Mariana Chilton
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Molly Knowles
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Sandra L. Bloom
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| |
Collapse
|
29
|
Graves SK, Little SJ, Hoenigl M. Risk profile and HIV testing outcomes of women undergoing community-based testing in San Diego 2008-2014. Sci Rep 2017; 7:42183. [PMID: 28165056 PMCID: PMC5292713 DOI: 10.1038/srep42183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/06/2017] [Indexed: 11/09/2022] Open
Abstract
Women comprised 19% of new HIV diagnoses in the United States in 2014, with significant racial and ethnic disparities in infection rates. This cross-sectional analysis of women enrolled in a cohort study compares demographics, risk behaviour, and sexually transmitted infections (STI) in those undergoing HIV testing in San Diego County. Data from the most recent screening visit of women undergoing voluntary HIV screening April 2008 -July 2014 was used. HIV diagnosis, risk behaviour and self-reported STIs were compared among women aged ≤24, 25-49, and ≥50, as well as between HIV-infected and uninfected women and between Hispanic and non-Hispanic women. Among the 2535 women included, Hispanic women were less likely than other women to report unprotected vaginal intercourse (p = 0.026) or stimulant drug use (p = 0.026), and more likely to report one or fewer partners (p < 0.0001), but also more likely to report sex with an HIV-infected individual (p = 0.027). New HIV infection was significantly more prevalent among Hispanic women (1.6% vs. 0.2%; p < 0.001). Hispanic women were more likely than other women to be diagnosed with HIV despite significantly lower rates of risk behaviour. Culturally specific risk reduction interventions for Hispanic women should focus on awareness of partner risk and appropriate testing.
Collapse
Affiliation(s)
- Susannah K. Graves
- Division of Infectious Diseases, University of California San Diego, San Diego, California, USA
| | - Susan J. Little
- Division of Infectious Diseases, University of California San Diego, San Diego, California, USA
| | - Martin Hoenigl
- Division of Infectious Diseases, University of California San Diego, San Diego, California, USA
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| |
Collapse
|
30
|
Sun J, Knowles M, Patel F, Frank DA, Heeren TC, Chilton M. Childhood Adversity and Adult Reports of Food Insecurity Among Households With Children. Am J Prev Med 2016; 50:561-572. [PMID: 26596189 DOI: 10.1016/j.amepre.2015.09.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/25/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Exposure to childhood adversity, including abuse, neglect, and household dysfunction, is associated with negative long-term health and economic outcomes. Little is known about how adversity exposure in parents' early lives may be related to later food insecurity for parents and their children. This study investigated the association between female caregivers' adverse childhood experiences (ACEs) and household and child food insecurity, taking into account depressive symptoms. METHODS This study used cross-sectional data from 1,255 female caregivers of children aged <4 years surveyed in an urban clinical setting from March 2012 through June 2014. Measures included sociodemographic characteristics; caregivers' ACEs, including abuse, neglect, and household dysfunction; depressive symptoms; and household and child food insecurity. Multinomial and logistic regression analyses assessed the relationship among ACEs, depressive symptoms, and household and child food security status. RESULTS Caregiver depressive symptoms modified associations between ACEs and food insecurity level. After adjusting for covariates, caregivers reporting both depressive symptoms and four or more ACEs were 12.3 times as likely to report low food security (95% CI=6.2, 24.7); 28.8 times as likely to report very low food security (95% CI=12.8, 64.8); and 17.6 times as likely to report child food insecurity (95% CI=7.3, 42.6) compared with those reporting no depressive symptoms and no ACEs. CONCLUSIONS Depressive symptoms and ACEs were independently associated with household and child food insecurity, and depressive symptoms modified the association between ACEs and household and child food insecurity. Comprehensive policy interventions incorporating nutrition assistance and behavioral health may address intergenerational transmission of disadvantage.
Collapse
Affiliation(s)
- Jing Sun
- Department of Epidemiology, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Molly Knowles
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Falguni Patel
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Deborah A Frank
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Mariana Chilton
- Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania.
| |
Collapse
|
31
|
Abstract
OBJECTIVE We estimated the prevalence of food insecurity among people who inject drugs (PWID) in Los Angeles and San Francisco and explored correlates of food insecurity. DESIGN A cross-sectional study that measured 30 d food insecurity using the US Adult Food Security Survey ten-item Module developed by the US Department of Agriculture. Food insecurity was defined as including low and very low food security. SETTING Two cities in the state of California, USA. SUBJECTS Male and female active PWID (n 777). RESULTS Among participants, 58 % reported food insecurity and 41 % reported very low food security. Food-insecure PWID were more likely to report being homeless (prevalence ratio (PR)=1·20; 95 % CI 1·05, 1·37), chest pain in the past 12 months (PR=1·19; CI 1·06, 1·35), acquiring syringes from someone who goes to a syringe exchange programme (PR=1·27; 95 % CI 1·13, 1·43) and feeling at risk for arrest for possession of drug paraphernalia (PR=1·30; 95 % CI 1·15, 1·46). CONCLUSIONS Current food insecurity was common among PWID in these two cities, yet few factors were independently associated with food insecurity. These data suggest that broad strategies to improve food access for this high-risk population are urgently needed.
Collapse
|