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Drug and alcohol dependence
09 01, 2020;214 108106.

Syndemic latent transition analysis in the HPTN 061 cohort: Prospective interactions between trauma, mental health, social support, and substance use.

Rodman E Turpin, Typhanye V Dyer, Derek T Dangerfield, Hongjie Liu, Kenneth H Mayer
Author Information
  1. Rodman E Turpin: Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD, United States. Electronic address: Rturpin@umd.edu.
  2. Typhanye V Dyer: Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD, United States.
  3. Derek T Dangerfield: Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
  4. Hongjie Liu: Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD, United States.
  5. Kenneth H Mayer: Fenway Health, Boston, MA, United States.
PMID: 32652374 DOI: 10.1016/j.drugalcdep.2020.108106

Abstract

BACKGROUND: Substance use among Black sexual minority men (BSMM) is a significant public health focus of prevention interventions due to its association with sexual risk behaviors and transmission of HIV. Traumatic experiences and mental health challenges may interact to create a syndemic associated with substance use in this population; this may be moderated by social support however.
METHODS: Using a multicenter prospective cohort of 1068 BSMM, we conducted a longitudinal syndemic latent transition analysis testing whether baseline and 6-month race and sexuality-targeted violence, intimate partner violence, other traumatic experiences, depression, and internalized homophobia was associated with 12-month substance use. We also tested if social support modified this and was associated with transitions between statuses.
RESULTS: Our analysis identified four statuses: A "low-risk" status characterized by the lowest proportions of syndemic factors, and 3 "high-risk" statuses, characterized by higher proportions of syndemic factors. All three high-risk statuses were associated with higher substance use than the low-risk status, with the greatest association observed with "high-risk status C" (aRR = 4.54, 95 % CI 1.98, 10.40). Social support attenuated this association (Interaction aRR = 0.21, 95 % CI 0.05, 0.85) and was associated with lower transition rates from low to high-risk status 6 months later (Transition ratio = 0.45, 95 % CI 0.29, 0.69).
CONCLUSIONS: Our findings identified a syndemic of trauma, depression, and homophobia among BSMM associated with substance use, but attenuated by social support. Future research into the role of social support and resiliency in substance use prevention and recovery is recommended.

Keywords

Black Depression Homophobia Latent variable Men who have sex with men Substance use Syndemic Trauma

References

  1. AIDS Care. 2016 Jul;28(7):866-72 [PMID: 26917328]
  2. Subst Use Misuse. 2018 Mar 21;53(4):559-564 [PMID: 28915073]
  3. Cult Health Sex. 2018 Dec;20(12):1424-1439 [PMID: 29589798]
  4. Drug Alcohol Depend. 2018 Sep 01;190:216-223 [PMID: 30055426]
  5. AIDS Behav. 2017 Jul;21(7):2023-2032 [PMID: 28025737]
  6. Cult Health Sex. 2018 Apr;20(4):411-427 [PMID: 28741417]
  7. PLoS One. 2016 Dec 9;11(12):e0167629 [PMID: 27936098]
  8. Sex Transm Dis. 2018 Mar;45(3):163-168 [PMID: 29420444]
  9. AIDS Behav. 2017 Oct;21(10):2958-2972 [PMID: 28352984]
  10. Lancet. 2012 Jul 28;380(9839):341-8 [PMID: 22819656]
  11. J Racial Ethn Health Disparities. 2015 Mar;2(1):1-10 [PMID: 25960944]
  12. AIDS Behav. 2017 Mar;21(3):845-857 [PMID: 27844298]
  13. AIDS Behav. 2018 Jun;22(6):1919-1931 [PMID: 29079948]
  14. J Homosex. 2020 May 11;67(6):816-832 [PMID: 30614402]
  15. PLoS One. 2013 Jul 26;8(7):e70413 [PMID: 23922989]
  16. Int J STD AIDS. 2017 Jan;28(1):91-93 [PMID: 27542697]
  17. Int J STD AIDS. 2017 Mar;28(4):362-366 [PMID: 27178067]
  18. J Acquir Immune Defic Syndr. 2018 Jun 1;78(2):163-168 [PMID: 29424789]
  19. J Urban Health. 2019 Jun;96(3):429-441 [PMID: 30136249]
  20. Drug Alcohol Depend. 2017 Jul 1;176:176-180 [PMID: 28549302]
  21. BMC Public Health. 2019 Apr 25;19(1):431 [PMID: 31023281]
  22. AIDS Care. 2017 May;29(5):545-551 [PMID: 27590043]
  23. PLoS One. 2013;8(3):e58067 [PMID: 23469262]
  24. J Health Soc Behav. 1995 Mar;36(1):38-56 [PMID: 7738327]
  25. Arch Sex Behav. 2019 Jan;48(1):213-224 [PMID: 29623533]
  26. Arch Suicide Res. 2016;20(1):80-93 [PMID: 26756389]
  27. AIDS Care. 2016 Dec;28(12):1566-1570 [PMID: 27241085]
  28. J Acquir Immune Defic Syndr. 2019 Mar 1;80(3):276-283 [PMID: 30531302]
  29. AIDS Care. 2016;28(1):112-8 [PMID: 26324405]
  30. Am J Mens Health. 2017 Sep;11(5):1309-1321 [PMID: 26758708]
  31. J Immigr Minor Health. 2019 Dec;21(6):1224-1232 [PMID: 30552541]
  32. AIDS Educ Prev. 2017 Oct;29(5):418-431 [PMID: 29068713]
  33. Med Anthropol Q. 2003 Dec;17(4):423-41 [PMID: 14716917]
  34. J Acquir Immune Defic Syndr. 2018 Aug 15;78(5):491-498 [PMID: 29771782]
  35. Am J Public Health. 2013 Jan;103(1):79-85 [PMID: 23153154]
  36. AIDS Patient Care STDS. 2018 Mar;32(3):112-118 [PMID: 29620925]
  37. AIDS Educ Prev. 2018 Aug;30(4):309-321 [PMID: 30148667]
  38. HIV Med. 2018 May 22;: [PMID: 29790254]
  39. Depress Anxiety. 2002;15(2):75-8 [PMID: 11891997]
  40. Pain Med. 2011 Apr;12(4):657-67 [PMID: 21392250]
  41. J Urban Health. 2017 Oct;94(5):666-675 [PMID: 28616719]
  42. J Drug Issues. 2010;40(1):93-120 [PMID: 20672019]
  43. J Urban Health. 2012 Aug;89(4):697-708 [PMID: 22383094]
  44. AIDS. 2007 Oct 1;21(15):2083-91 [PMID: 17885299]
  45. AIDS Care. 2018 Aug;30(sup5):S27-S38 [PMID: 30632775]
  46. Int J Drug Policy. 2016 Oct;36:148-50 [PMID: 26874991]
  47. J Adolesc Health. 2016 Nov;59(5):599-601 [PMID: 27544456]
  48. Am J Mens Health. 2018 Mar;12(2):292-301 [PMID: 26873342]
  49. Subst Use Misuse. 2017 Jan 2;52(1):100-107 [PMID: 27679931]
  50. AIDS Behav. 2017 Apr;21(4):1163-1170 [PMID: 27480454]

Grants

  1. U48 DP006382/NCCDPHP CDC HHS
  2. P30 AI094189/NIAID NIH HHS
  3. UM1 AI069412/NIAID NIH HHS
  4. UM1 AI068619/NIAID NIH HHS
  5. P2C HD041041/NICHD NIH HHS
  6. UM1 AI068613/NIAID NIH HHS
  7. P30 AI060354/NIAID NIH HHS

MeSH Term

Adult
Black or African American
Cohort Studies
Depression
HIV Infections
Humans
Intimate Partner Violence
Male
Mental Health
Middle Aged
Prospective Studies
Risk-Taking
Sexual Behavior
Sexual and Gender Minorities
Social Support
Substance-Related Disorders
Syndemic
Wounds and Injuries
Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S.
Article has an altmetric score of 2

Word Cloud

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