Social Support as a Moderator between Syndemics and Posttraumatic Stress among Women Experiencing Adversity

ABSTRACT

Substance Abuse, Violence, and AIDS/HIV (i.e., SAVA) tend to co-occur and the clustering of these adversities may be associated with increased psychopathology. Little is known about how these co-existing adversities affect the mental health of women. Further, few studies have examined protective factors that could weaken the relationship between these SAVA adversities and posttraumatic stress symptoms (PTSS). The current study assessed this relationship, as well as the moderating effect of social support. Participants included 178 women (M_age = 35.23, SD = 8.44; 71.0% Black) who were living with HIV, experiencing intimate partner violence, and/or using illicit substances. Women were recruited from community organizations and completed hour-long interviews. Findings indicated that experiencing more than one SAVA was associated with greater PTSS (ß =.28; p =.036). Results also supported the moderating role of social support (F(2,168) = 3.41, p=.035, R² =.31, f² =.45). Among women with higher levels of support, having one SAVA adversity was associated with lower PTSS. However, among women with lower levels of support, having one SAVA was associated with higher PTSS. Results not only underscore how co-occurring adversities exacerbate PTSS, but also highlight the central role of social support as a protective factor among women.

KEYWORDS:

• Intimate partner violence
• substance use
• HIV/AIDS
• PTSS
• psychopathology

Acknowledgments

We would like to thank the women and community partners who made this research possible, as well as the graduate and undergraduate research assistants who helped with data collection.

Disclosure of interest

All authors declare that they have no conflicts to report.

Ethical standards and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation at the University of Memphis and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

Additional information

Funding

This study was supported by the University of Memphis Faculty Research Grant Fund to Kathryn Howell, Principal Investigator and the University of Memphis Diversity Research Grant to Idia Thurston, Principal Investigator. This support does not necessarily imply endorsement by the University of Memphis of the study’s research conclusions. Authors’ effort was also funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development R15HD089410 to Kathryn Howell, Principal Investigator.