Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection

Abstract

We examined a model of stress and coping in 749 African-American women at risk for HIV infection. Women in the sample were either homeless, intravenous drug users (IVDUs) sexual partners of IVDUs, or prostitutes. A model was hypothesized based on stress and coping theory and research. Antecedents studied were personal resources, specifically self-esteem and available support. Mediators were threat appraisal and coping efforts. Outcomes studied were emotional distress and HIV risk behaviors. Structural equation modeling techniques were used to test hypothesized pathways between these variables. Forty-five percent of the variance in emotional distress in these women was explained by the model with self-esteem and avoidant coping the strongest predictors. Ten percent of the variance in risk behavior was explained by the model with emotional distress the strongest predictor. Direct and indirect pathways predicting risk behavior and distress are discussed. Implications of results for intervention and theory building are considered.

Psychosocial predictors of AIDS risk behavior and drug use behavior in homeless and drug addicted women of color.

“…Researchers have demonstrated that persons who perceive fewer threats in their environment and who cope more adaptively experience lower levels of emotional distress (Fawzy et al, 1990;Namir, Wolcott, Fawzy, & Alumbaugh, 1987) and engage in less risky behaviors (Nyamathi, Wayment, et al, 1993). The impact of threat appraisal on barriers to condom use is likewise of interest in this study.…”

“…Measures used to construct the latent variables are described below. Content validity of the scales and measures used in the interviews was previously established through review and consensus of a 12-member panel experienced in the areas of AIDS, ethnic/racial diversity, and coping (for more details see Nyamathi, Wayment, et al, 1993). Before the measurement model (CFA) and path models were tested with structural modeling, preliminary exploratory factor analyses were conducted to determine the optimum configuration for each latent construct.…”

“…In this study, threat appraisal is defined more personally as degree of threat over losing self-respect, being considered useless, having insufficient money, and being involved in illegal activities (Nyamathi, Wayment, et al, 1993). Researchers have demonstrated that persons who perceive fewer threats in their environment and who cope more adaptively experience lower levels of emotional distress (Fawzy et al, 1990;Namir, Wolcott, Fawzy, & Alumbaugh, 1987) and engage in less risky behaviors (Nyamathi, Wayment, et al, 1993).…”

“…Thus it was hypothesized that women with higher self-esteem would have less emotional disturbance and fewer perceived threats in their environment, would use more active coping and less avoidant coping, and would report less sexual and drug use behavior and fewer barriers to protective behaviors such as use of condoms. Moreover, as emotional distress has been found to be associated with higher level of threat appraisal and avoidant coping (Nyamathi, Wayment, et al, 1993) and higher rates of HIV risk behavior (Tucker, 1982;Nyamathi, 1992;Nyamathi, Wayment, et al, 1993), it was hypothesized that women with higher emotional disturbance would report more threat appraisal, more barriers to condom use, more avoidant coping, and greater risky behavior.…”

“…The purpose of this study was to examine a causal model of personal resources, threat appraisal processes, coping styles, and barriers to risk reduction as predictors of risk behavior among a group of high-risk women. This study represents a subsample of a larger study designed to study coping skills and health outcome of homeless and drug addicted women of color in Los Angeles (Nyamathi, 1991(Nyamathi, , 1992Nyamathi, Wayment, & Dunkel-Schetter, 1993). Risk behavior was defined as (a) general AIDS risk behaviors such as multiple sex partners, injection-drug-using sex partners, and less condom use, and (b) specific risky drug use behaviors such as sharing needles.…”