Stress processes in HIV-positive African American mothers: Moderating effects of drug abuse history

Abstract

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed. KeywordsDrug abuse history; HIV/AIDS; African American women; stress process model The HIV/AIDS epidemic represents a growing and persistent health threat to women, especially women of color. The Centers for Disease Control and Prevention (CDC&P, 2005) reported that AIDS was the 6th leading cause of death among all women aged 25 to 34 years and the 4th leading cause of death among all women aged 35 to 44 years. Additionally, the rate of AIDS diagnoses for African American women was approximately 25 times the rate for white women and 4 times the rate for Hispanic women. AIDS is now the leading cause of death for African American women aged 25 to 34 years and is among the four leading causes of death for African American women aged 20 to 24 and 35 to 44 years.

Hiv Positive Mothers; Issues and Concerns: A Qualitative Study

“…[12][13][14][15] Discrimination at schools, work places and humiliation is very common in most of the places across the world. [16][17][18][19][20][21] In this study the positive network has given the suffering woman, knowledge, hope and support. A study conducted by Michael Robbins also gives similar findings.…”

Maternal-Fetal Attachment and Health Behaviors among Women with HIV/AIDS

“…Nonetheless, its contribution to the medium predictive relationship assessed in this regression analysis is minimal. In contrast, multiple studies in the research literature found relationships between poor health behaviors among HIVinfected pregnant women and either a history of substance use, a substance abuse diagnosis, or an active substance use problem (Burns et al, 2008;Mellins et al, 2003;Napravick et al, 2000). Do variables measuring risks for poor maternal health behaviors, such as history of substance use diminish when examined in conjunction with potential protective factors against adversity or facilitators of wellbeing?…”

“…Mothers with history of drug use diagnosis, compared to those without this history, reported stronger effect of avoidant coping on psychological distress, and employed larger support networks as a means of coping (Burns et al, 2008). However, women with a history of drug abuse did not benefit as much from the increased social support, as did those without this history (Burns et al, 2008). Mellins et al (2002) found that a diagnosis of psychiatric or substance abuse disorders and parenting stress strongly correlated with ART non-adherence in a cohort of HIV-infected mothers living in a U.S.…”

“…Measures of the marital partner status and the history of substance use variables were included in the maternal-fetal attachment model because they capture participants' socio-demographic characteristics, which are theoretically and empirically associated to the maternal health behaviors investigated in this study (Burns et al, 2008;Demas et al, 2005;Mellins et al, 2003;Riley et al, 2011). Most of the participants in this study reported being single or not living with a marital partner, regardless of this partner being the father of the infant they were expecting.…”

“…The prevalence of substance abuse pre-and during pregnancy among HIV-infected women is high enough to indicate concern for its effect on the women's health, health behaviors and overall wellbeing (Bardaguez et al, 2008;Ethier et al, 2002). Mothers with history of drug use diagnosis, compared to those without this history, reported stronger effect of avoidant coping on psychological distress, and employed larger support networks as a means of coping (Burns et al, 2008). However, women with a history of drug abuse did not benefit as much from the increased social support, as did those without this history (Burns et al, 2008).…”