A Syndemic Model of Substance Abuse, Intimate Partner Violence, HIV Infection, and Mental Health Among Hispanics

Abstract

Hispanics are disproportionately affected by substance abuse, HIV infection, intimate partner violence, and mental health conditions. To address health disparities among Hispanics and other vulnerable groups, it is necessary to understand the complex interactions between health conditions clustering together (e.g., substance abuse, intimate partner violence, and HIV) and the social ecology in which these conditions exist. A syndemic orientation, a consideration of clustering epidemics and common individual, relationship, cultural, and socioenvironmental factors linking these conditions, may be helpful in developing comprehensive models that expand our ability to understand and address health disparities. The purpose of this paper is to introduce a Syndemic Model of Substance Abuse, Intimate Partner Violence, HIV Infection, and Mental Health among Hispanics, and provide evidence from the research literature to support the central relationships and risk and protective factors (i.e., potential links between conditions) depicted by the model. The development and evaluation of interventions aimed at the prevention of substance abuse, intimate partner violence, HIV/AIDS, and mental health problems as a syndemic affecting Hispanics is urgently needed. Public health nurses can initiate this endeavor with the guidance of a Syndemic Model.

Co-occurring Health Risks Among Middle Aged Hispanic Men Who Have Sex With Men (HMSM) in South Florida

“…Participants who were older were less likely to report substance abuse in the past three months (AOR = 0.93, 95% CI = 0.89, 0.97) and participants reporting increased depressive symptoms were more likely to report substance abuse (AOR = 1.05, 95% CI = 1.01, 1.09). The findings from this study supports previous research findings linking depressive symptoms with substance use/abuse in Hispanic men (Gonzalez-Guarda, Florom-Smith, & Thomas, 2011;Gonzalez-Guarda et al, 2010;Maisto, Palfai, Vanable, Heath, & Woolf-King, 2012). Additionally, this contradicts this study's proposed hypothesis that increased age in middle age HMSM may increase risk for depression; however, this study was not exclusively middle age HMSM.…”

Relationship of Physical Intimate Partner Violence with Mental Health Diagnoses in the Nationwide Emergency Department Sample

“…The Centers for Disease Control and Prevention defines IPV as ''physical violence, sexual violence, threats of physical/sexual violence, and psychological/emotional abuse perpetrated by a current or former spouse, common-law spouse, nonmarital dating partners, or boyfriends/girlfriends of the same or opposite sex.'' 4,5 Previous studies have linked IPV to a wide range of adverse health consequences, including injury, 3,[6][7][8] chronic pain, 9,10 gastrointestinal disorders, [11][12][13] sexually transmitted diseases, [14][15][16][17] disability, 18,19 poor pregnancy outcomes, 20 substance abuse, [21][22][23] depression, 24,25 post-traumatic stress disorder (PTSD), 26,27 and death. 28 Clearly, a gender gap exists in susceptibility to violence in general and IPV in particular, with most national surveys suggesting higher IPV rates in women versus men.…”

HIV Sexual Risk and Syndemics among Women in Three Urban Areas in the United States: Analysis from HVTN 906

“…[4][5][6] In addition, social and economic disadvantage, homelessness, and incarceration have been shown to be associated with sexual risk behavior and HIV infection. [7][8][9][10][11][12][13][14][15][16] Partner-related or sexual network factors have also been shown to be important in HIV risk among women, including sexual partner drug use, partner incarceration, concurrent sexual partnerships and assortative mixing (e.g., sex with other people from the same race and/or ethnicity). 7,9,[17][18][19][20] Limited data are available on the longitudinal occurrence of syndemic factors among women and how these factors relate to sexual risk over time.…”