Impact of intimate partner violence, substance use and HIV on depressive symptoms among low-income urban women - honorable mention Kenneth Lutterman Award for Exemplary Student Paper in Mental Health

Intimate partner violence (IPV), HIV/AIDS and substance use are among the most significant health problems affecting low-income urban women. Evidence indicates that these problems often co-occur for women, and are connected epidemics making up a “syndemic.” Research suggests that each issue separately is associated with depressive symptoms, but no studies have examined the combined effect of IPV, HIV and substance use on women's depression. Interviews were conducted with 96 women recruited from community health clinics serving low-income women in an urban US city. All women were over 17, not pregnant, English-speaking, without private insurance and experienced physical IPV in the past year. Women were primarily African American (82%) and 82% were receiving income assistance. Twenty seven percent were HIV-positive, and 27% had used heroin or cocaine in the past 6 months. Based on the CES-D Short Form, 73% were depressed. Drug use and severe IPV in the past 6 months were significantly and independently associated with depression; women who experienced severe IPV were 5.8 times more likely to be depressed, controlling for HIV status and drug use. Among those who experienced IPV, were HIV-positive and used drugs (7.3% of sample), all were depressed. These findings suggest that severe IPV is significantly associated with depression among urban women and that the syndemic effect of IPV, HIV and drug use could be even more detrimental to women's mental health. This has implications for mental health, drug treatment, IPV and HIV service providers as they address these intersecting health issues among their patients.