Samantha L Illangasekare1, Jessica G Burke2, Geetanjali Chander3, Andrea C Gielen4. 1. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: sillanga@jhsph.edu. 2. Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania. 3. Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland. 4. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Abstract
BACKGROUND: Intimate partner violence (IPV), HIV/AIDS, and substance use are described as the SAVA "syndemic" among low-income urban women because of their intersecting and synergistic presence in these women's lives. Depressive symptoms are significantly associated with these SAVA factors and although social support is potentially protective for depression, little is understood about its impact on depression associated with the SAVA syndemic. METHODS: This paper investigates how women living with SAVA experience and describe depressive symptoms, and examines how the types of social support they access impact their experiences of SAVA and depressive symptoms. Qualitative, in-depth interviews were conducted with 24 HIV-positive, low-income, urban women who experienced IPV and used cocaine or heroin in their lifetime. Interviews were analyzed based on study aims, principles of thematic content analysis, and grounded theory. RESULTS: Women identified multiple SAVA factors as catalysts for depression and noted their synergistic effect on depressive symptoms, which were both a trigger for and a result of drug use. Women accessed varying sources of social support to address their SAVA factors and associated symptoms of depression, relying on informal sources for instrumental support related to IPV and formal sources for support related to HIV, drug use, and depression. CONCLUSIONS: These findings have important implications for health providers who serve SAVA-affected women, and suggest that comprehensively addressing all SAVA factors (and IPV in particular) and improving their access to quality social support at critical times is essential to improve their mental health.
BACKGROUND: Intimate partner violence (IPV), HIV/AIDS, and substance use are described as the SAVA "syndemic" among low-income urban women because of their intersecting and synergistic presence in these women's lives. Depressive symptoms are significantly associated with these SAVA factors and although social support is potentially protective for depression, little is understood about its impact on depression associated with the SAVA syndemic. METHODS: This paper investigates how women living with SAVA experience and describe depressive symptoms, and examines how the types of social support they access impact their experiences of SAVA and depressive symptoms. Qualitative, in-depth interviews were conducted with 24 HIV-positive, low-income, urban women who experienced IPV and used cocaine or heroin in their lifetime. Interviews were analyzed based on study aims, principles of thematic content analysis, and grounded theory. RESULTS:Women identified multiple SAVA factors as catalysts for depression and noted their synergistic effect on depressive symptoms, which were both a trigger for and a result of drug use. Women accessed varying sources of social support to address their SAVA factors and associated symptoms of depression, relying on informal sources for instrumental support related to IPV and formal sources for support related to HIV, drug use, and depression. CONCLUSIONS: These findings have important implications for health providers who serve SAVA-affected women, and suggest that comprehensively addressing all SAVA factors (and IPV in particular) and improving their access to quality social support at critical times is essential to improve their mental health.
Authors: Ann L Coker; Keith E Davis; Ileana Arias; Sujata Desai; Maureen Sanderson; Heather M Brandt; Paige H Smith Journal: Am J Prev Med Date: 2002-11 Impact factor: 5.043
Authors: Mary F Morrison; John M Petitto; Thomas Ten Have; David R Gettes; Margaret S Chiappini; Anita L Weber; Priscilla Brinker-Spence; Russell M Bauer; Steven D Douglas; Dwight L Evans Journal: Am J Psychiatry Date: 2002-05 Impact factor: 18.112
Authors: Paula Braitstein; Kathy Li; Mark Tyndall; Patricia Spittal; Michael V O'Shaughnessy; Arn Schilder; Caitlin Johnston; Robert S Hogg; Martin T Schechter Journal: Soc Sci Med Date: 2003-08 Impact factor: 4.634
Authors: Jacqueline de Souza; Letícia Yamawaka de Almeida; Jordana Luiza Gouvêa de Oliveira; Adriana Inocenti Miasso; Sandra Cristina Pillon; Marciana Fernandes Moll Journal: Community Ment Health J Date: 2019-06-07
Authors: Isabel Martinez; Trace S Kershaw; Danya Keene; Rafael Perez-Escamilla; Jessica B Lewis; Jonathan N Tobin; Jeannette R Ickovics Journal: Ann Behav Med Date: 2018-01-05
Authors: Elise D Riley; Eric Vittinghoff; Catherine A Koss; Katerina A Christopoulos; Angelo Clemenzi-Allen; Samantha E Dilworth; Adam W Carrico Journal: AIDS Behav Date: 2019-09
Authors: Lauren Lipira; Emily C Williams; Paul E Nevin; Christopher G Kemp; Susan E Cohn; Janet M Turan; Jane M Simoni; Michele P Andrasik; Audrey L French; Joseph M Unger; Patrick Heagerty; Deepa Rao Journal: J Acquir Immune Defic Syndr Date: 2019-06-01 Impact factor: 3.731
Authors: Sara LeGrand; Susan Reif; Kristen Sullivan; Kate Murray; Morgan L Barlow; Kathryn Whetten Journal: Curr HIV/AIDS Rep Date: 2015-12 Impact factor: 5.071
Authors: Theresa E Matson; Kathleen A McGinnis; Anna D Rubinsky; Madeline C Frost; Maggie Czarnogorski; Kendall J Bryant; E Jennifer Edelman; Derek D Satre; Sheryl L Catz; Kara M Bensley; David A Fiellin; Amy C Justice; Emily C Williams Journal: AIDS Date: 2018-09-24 Impact factor: 4.177