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

作者：Robinson Allysha C; Knowlton Amy R; Gielen Andrea C; Gallo Joseph J

来源：Journal of Behavioral Medicine, 2016, 39(1): 1-12.

DOI：10.1007/s10865-015-9670-1

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

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

• 出版日期2016-2