Trauma and Psychosocial Predictors of Substance Abuse in Women Impacted by HIV/AIDS

ArticleinThe Journal of Behavioral Health Services & Research 36(2):233-46 · April 2009with5 Reads
DOI: 10.1007/s11414-008-9134-2 · Source: PubMed
Abstract
The purpose of this study was to estimate the relative contributions of trauma, chronic stress burden, depression, anxiety, social support, and social undermining in predicting alcohol and drug abuse, and whether ethnicity moderated these relationships. A multi-ethnic sample of 288 HIV-positive and HIV-negative women was recruited. Multiple group path analysis indicated that greater drug dependence was associated with being HIV+, more depression, and higher chronic burden. Trauma was related only to anxiety. Also, greater alcohol dependence was associated with more depression and more social undermining, and these effects were moderated by ethnicity. African American and Latina women evidenced different relationships between depression, social support and social undermining. Depression, social support and social undermining served as intervening variables in influencing the relationships between the other psychosocial variables and drug and alcohol dependence. The implications of these findings for alcohol and drug abuse research and services are discussed.
    • "Item 10 which referred to substance abuse related to HIV/AIDS was removed. We found that most of the participants (86.7%) reported no increased drug/alcohol intake related to HIV/AIDS, although some prior research has shown that life stress is associated with increased substance use in people living with HIV [10, 42]. Meade's study also found that substance abuse was the least commonly endorsed item among the 23 items [27] . "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Apr 2016
    • "Alcohol problems among women have been associated with many factors that are common in the lives of HIV-positive Latinas and African American women, including childhood physical , emotional, and sexual abuse (Galaif, Stein, Newcomb, & Bernstein, 2001; Zule, Flannery, Wechsberg, & Lam, 2002), intimate partner violence (Moreno, 2007), and entry into the welfare system (Dooley & Prause, 2002 ). Related to the substance abuse and high-risk heterosexual sex through which Latinas and African American women are most likely to become infected with HIV (Kaiser Family Foundation, 2011), alcohol use may also be a significant contributor to the HIV-related health disparities that the women experience after diagnosis (Myers et al., 2009). Despite the awareness of the potential links between alcohol use and HIV/AIDS among women of color, virtually no research has explored the etiology and impact of alcohol use among HIV-positive Latinas and African American women. "
    [Show abstract] [Hide abstract] ABSTRACT: This analysis of focus group dialogues about the intersection of race/ethnicity, HIV/AIDS, and alcohol use among HIV-positive Latinas and African American women explores consumers’ and providers’ perspectives on issues that influence the misuse of alcohol, the mechanisms of that influence, and factors that are critical to addressing the misuse of alcohol successfully in this population. The findings highlight the social structural influences of gender, race/ethnicity, and poverty and the interpersonal influences of family relationships, the disclosure of HIV, trauma and abuse, romantic partnerships, and motherhood on the misuse of alcohol. The discussion highlights suggestions for gender-specific and culturally responsive elements of alcohol treatment for HIV-positive Latinas and African American women.
    Full-text · Article · Nov 2012
    • "However, exploration of this connection in humans has met significant conceptual and methodological challenges, especially related to the definition and measurement of psychosocial stressors (Brady & Sonne, 1999; Goeders, 2004; Wills, 1990). Prior studies in the drug field have explored a range of psychosocial stressors, including childhood victimization and other negative life events, life transitions, daily hassles, social role strains, and socioeconomic disadvantage (Bennett & Kemper, 1994; Boardman, Finch, Ellison, Williams, & Jackson, 2001; Boyd, 1993; Boyd et al., 2002; Crutchfield & Gove, 1984; Davis, 1997; Freeman, Collier, & Parillo, 2002; Johnson & Young, 2002; Liu & Kaplan, 2001; Medrano, Zule, Hatch, & Desmond, 1999; Myers et al., 2009; Newcomb & Harlow, 1986; Pearlin & Radabaugh, 1976; Skeer et al., 2009; Storr, Trinkoff, & Anthony, 1999; Teets, 1995; Widom, Weiler, & Cottler, 1999; Wills, 1990; Young, Boyd, & Hubbell, 2002). Although many studies found a positive association between psychosocial stress and drug use, others produced inconsistent findings (Allan & Cooke, 1985; Lindenberg, Reiskin, & Gendrop, 1994; Sinha, 2001). "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Dec 2011
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