A Substance Abuse, Violence and Unhealthy Alcohol Use Syndemic Predicts Depression: A Longitudinal Study of Black Women Living With HIV in Four US Cities
Year: 2026
Type: article
Abstract: OBJECTIVE: Black women living with HIV (BWLH) have a heightened susceptibility to depression due to factors such as intimate partner violence (IPV), alcohol use, and substance abuse. This study examined the relationship between Substance Abuse, Violence, and Heavy Alcohol use (SAVA) among BWLH to determine whether this relationship creates distinct syndemic classes and whether class membership was associated with depressive symptoms. METHODS: Data for this study were drawn from the WAVE sub-study, which included women enrolled in the WIHS (n = 363) collected between April 2016 and April 2017 in four US cities. Latent class analysis was used to identify subgroups based on cannabis use, alcohol use, substance use, and violence. Regression analyses explored the association between baseline syndemic class membership and depressive symptoms at 6, 12, and 18 months. RESULTS: Three latent classes were identified: "syndemic," "non-syndemic low substance use," and "non-syndemic moderate cannabis use." Women in the syndemic class, characterized by higher levels of substance use and violence, had significantly higher depressive symptoms compared to those in the non-syndemic classes. Longitudinal regression revealed that membership in the syndemic class was associated with a 54% increased risk of depressive symptoms at 6 months, 34% at 12 months, and 51% at 18 months. Bidirectional analyses indicated that baseline violence was associated with increased risk for substance use, and vice versa. CONCLUSIONS: Findings highlight the high prevalence of SAVA syndemic factors and their association with depressive symptoms among BWLH and the need for integrated and culturally competent care that addresses both mental health and syndemic factors to improve outcomes for this vulnerable population.
Source: Brain and Behavior
DOI: 10.1002/brb3.71609
Institutions: University of Maryland, College Park, George Mason University, The Ohio State University, Centers for Disease Control and Prevention, University of Alabama at Birmingham, UAB Medicine, University of Mississippi Medical Center, University of Mississippi, San Francisco VA Medical Center, University of California, San Francisco, Columbia University, Johns Hopkins University, SUNY Downstate Health Sciences University
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,630
Awards: Translational Biomedical Science Training Grant, Latent class analysis of syndemic factors associated with HIV care outcomes among women living with HIV in the South, Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS), Clinical and Translational Science Institute, University of Miami Developmental HIV/AIDS Mental Health Research Center (D-ARC), G7262207741, Institutional Career Development Core, Johns Hopkins Institute for Clinical and Translational Research, University of Pittsburgh MACS/WIHS CCS, MACS/WIHS -CCS, SF Bay Area MACS/WIHS Combined Cohort Study, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, Training for Scientists Conducting Research to Reduce HIV/AIDS Health Disparities, Center for AIDS Research at Emory University, Synergistic epidemics of non-communicable diseases, stigma, depression, and material insecurities among sexual and gender minorities living with HIV in Nigeria, Northwestern CORE Clinical Research Site: Trans-omics for HIV/AIDS Research, Los Angeles CRS for the MACS/WIHS Combined Cohort Study, Data Analysis and Coordination Center for the MACS-WIHS Combined Cohort Study, A community-based intervention to increase PrEP initiation in Prince George's County, Maryland: Reducing PrEP misinformation and increasing social support, MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS), The University of North Carolina Center for AIDS Research, MACS/WIHS Combined Cohort Study: Brooklyn Clinical Research Site (Bklyn CRS), Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, Evaluation of Neurobiological Mechanisms Mediating the Effect of Immune Activation on Neurocognitive Impairment and the Role of Psychosocial Factors Among Women Living with HIV, Atlanta MACS/WIHS Combined Cohort Study Clinical Research Site, UAB-MISS MACS/WIHS Combined Cohort Study, Miami Center for AIDS Research, UCLA Clinical and Translational Science Institute, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), A behavioral intervention for African-American gay and bisexual men living with HIV to address stigma-related barriers to antiretroviral therapy adherence
OpenAlex ID: W7172002606