Influence of social support, sense of community, experience of community violence, and trauma history on sexual risk, substance use, and victimization in African American women
Background: Bioecological Systems Theory (BST; Bronfenbrenner, 1993) may help us understand the context of multiple risk issues in low income African American women at disproportionate HIV risk. Preliminary baseline data from an ongoing prospective study were used to examine one of several BST-based models, including individual and sociocultural variables as they relate to sexual risk, substance use, and victimization. Method: Participants were African American women living in public housing developments in Milwaukee, WI (N=245). Baseline ACASI interviews assessed individual [trauma history (physical abuse, sexual coercion)], and sociocultural [social support (SS), experience of community violence, sense of community] variables as they relate to substance use [SU: alcohol and drug problems, days use total], recent victimization, and sexual risk (proportion of unprotected to all vaginal sex occasions). Non-normally distributed data were transformed. We performed structural equation modeling (SEM) with exogenous predictors and latent variables, and fit a reduced form of the model using WLSMV. Fit was confirmed using MPlus' (v.7) adjusted chi-square goodness-of-fit index. Results: When community-level variables and trauma history were introduced, relationships between substance use, victimization and sexual risk became nonsignificant. Significant relationships included (SE): Trauma history on Violence experience [.470 (.052), p<.000], SS [.418 (.140), p=.003], victimization [.474 (.120), p<.000], and SU [.637 (.075); p<.000]; and SS on sense of community [.-.216 (.037), p<.000]. Chi-Square(120) = 542.962, p <.0000; CFI = .891; TLI = .862; RMSEA = .045. Conclusions: These preliminary findings suggest the importance of addressing trauma history and sociocontextual variables in HIV risk reduction intervention content.
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences
Define syndemic as it pertains to the intersection of sexual risk, substance use and victmization in low income African American women
Analyze the applicability of Bronfenbrenner's (1983) multi-level Bioecological Systems Theory (BST) to address multiple risk issues related to syndemic
Keyword(s): Sexual Risk Behavior, Women
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been the principal or co-investigator of multiple federally funded grants focusing on HIV sexual risk reduction interventions, and the intersection of HIV sexual risk with substance use and other behavioral health issues. Among my scientific interests has been the development of strategies for preventing HIV and STDs in urban populations and persons with serious and persistent mental illness.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.