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William A. Zule, DrPH1, Wendee M. Wechsberg, PhD1, Wendy K.K. Lam, PhD1, Kara S. Riehman, PhD1, Georgiy Bobashev, PhD2, and Rachel Middlesteadt-Ellerson, BS1. (1) Substance Abuse Treatment Evaluations and Interventions, RTI International, PO Box 12194, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, 919.485.2797, zule@rti.org, (2) Statistics Program, Research Triangle Institute, 3040 Cornwallis Rd, Bldg. Cox 1, Research Triangle Park, NC 27709
Psychological distress has been associated with increased risk of HIV and may interfere with behavioral interventions to reduce HIV risk and substance abuse among drug users. Most studies of psychological distress among drug users have focused on individual drug users. However, contextual factors such as social support and neighborhood characteristics are increasingly associated with both physical and mental health status. This study examines the influence of contextual factors on health status, depression, and anxiety among crack users. Data were collected from 460 out-of-treatment African-American crack users in North Carolina. Their mean age was 40 years, and 28% were female. Self reports of safety within the neighborhood, awareness of criminal activity, and social support from friends and relatives were included in a multiple regression model predicting health status, depression, and anxiety. After controlling for individual socio-demographic characteristics and previously identified predictors of depression and anxiety among drug users (e.g. homelessness, childhood trauma, etc.), social support and neighborhood characteristics were independent predictors of depression and anxiety scores. Safety within the neighborhood was the most important predictor of both depression and anxiety scores, accounting for 8% of the variance in each model. Social support from friends predicted about 2% of the variance in each model. These findings provide support for understanding contextual (social and environmental) factors in intervention, treatment, and epidemiological studies of drug users. Furthermore, findings illustrate the benefits of a multi-disciplinary approach that draws on social epidemiology in addition to more traditional disciplines to understand individual behavior and mental health.
Learning Objectives: At the conclusion of the session, the participant will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.