COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South.

3区 综合性期刊
Carrie L Nacht, Hannah E Reynolds, Chadwick K Campbell, Kirstin Kielhold, Wilson Vincent, Daniel E Siconolfi, Susan M Kegeles, Erik D Storholm
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引用次数: 0

Abstract

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth.

Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach.

Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement.

Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness.

2019冠状病毒病与亲密伴侣暴力、精神健康、药物使用和美国南部感染艾滋病毒的黑人性少数男性艾滋病毒护理参与的综合
背景:黑人性少数男性(BSMM)不成比例地受到艾滋病毒发病率的影响,并且参与艾滋病毒护理的比例较低(例如,保留护理,病毒抑制),特别是在美国南部。COVID-19大流行加剧了同时发生的心理社会综合症因素(如抑郁、暴力、药物使用),这些因素对感染艾滋病毒的BSMM+ (BSMM+)产生了不成比例的影响,但大流行对美国南部BSMM+中艾滋病毒护理参与的影响尚未深入探讨。方法:从德克萨斯州达拉斯和休斯顿的纵向队列中招募BSMM+ (n = 27)。在2022年6月至2023年8月期间,有目的地选择参与艾滋病毒护理不理想、以前有亲密伴侣暴力经历(IPV)和自我报告药物使用流行率的参与者进行深度访谈。访谈平均持续54分钟,在应用主题分析方法之前进行录音、转录和去识别。结果:超过一半的参与者经历过与IPV的关系,在过去的60天内使用非法物质,并感到抑郁。采访强调,在2019冠状病毒病大流行期间,抑郁、药物使用和IPV水平的提高单独或协同抑制了抗逆转录病毒治疗的坚持和艾滋病毒护理的参与。参与者描述了IPV如何使他们的精神健康和药物使用恶化,而这反过来又是艾滋病毒护理参与不力的核心驱动因素。结论:研究结果表明,COVID-19大流行加剧了IPV、精神健康和药物使用的综合征,这些都是参与艾滋病毒护理的障碍。未来的依从性干预措施应协同解决综合征因素,以最大限度地提高疗效。
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来源期刊
自引率
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发文量
14422
期刊介绍: International Journal of Environmental Research and Public Health (IJERPH) (ISSN 1660-4601) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes, and short communications in the interdisciplinary area of environmental health sciences and public health. It links several scientific disciplines including biology, biochemistry, biotechnology, cellular and molecular biology, chemistry, computer science, ecology, engineering, epidemiology, genetics, immunology, microbiology, oncology, pathology, pharmacology, and toxicology, in an integrated fashion, to address critical issues related to environmental quality and public health. Therefore, IJERPH focuses on the publication of scientific and technical information on the impacts of natural phenomena and anthropogenic factors on the quality of our environment, the interrelationships between environmental health and the quality of life, as well as the socio-cultural, political, economic, and legal considerations related to environmental stewardship and public health. The 2018 IJERPH Outstanding Reviewer Award has been launched! This award acknowledge those who have generously dedicated their time to review manuscripts submitted to IJERPH. See full details at http://www.mdpi.com/journal/ijerph/awards.
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