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

Substance use, mental illness, and familial conflict non-negotiation among HIV-positive African-Americans: latent class regression and a new syndemic framework.
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DOI:
10.1007/s10865-015-9670-1
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发表时间:
2016-02
影响因子:
3.1
通讯作者:
Gallo, Joseph J.
Gallo, Joseph J.
中科院分区:
心理学3区
文献类型:
--
作者:
Robinson, Allysha C.;Knowlton, Amy R.;Gielen, Andrea C.;Gallo, Joseph J.

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我们评估了艾滋病毒阳性注射吸毒者(IDU)中物质使用、精神疾病和家庭冲突不协商的协同流行病(综合征)。使用基线BEACON研究数据。潜在分类分析确定了综合征分类。这些类别按性别、病毒抑制和未使用急症护理进行回归。假设女性比男性有更高的疾病负担和更差的健康结果。9%的参与者有高物质使用/精神疾病患病率(第4类);23%的患者所有因素均为中等水平(3类);25%有高度精神疾病(2类);43%有中度药物使用/精神疾病(1类;N=331)。与1-3类患者相比,4类患者以女性患者居多(p< 0.05),她们获得病毒抑制的可能性较低,使用急性护理的可能性较高(p< 0.05)。干预措施应针对非裔美国人IDU女性,以提高其负面医疗结果的风险。研究结果支持艾滋病毒综合综合干预方法,而不是单一的治疗方法。
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.
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