Resilience as a moderator between syndemics and depression in mothers living with HIV

ABSTRACT

Physical and emotional adversities in mothers have rippling effects across the family system. While an association between individual maternal adversities and problematic mental health outcomes has been established, less is known about co-existing adversities in mothers. Consistent with the syndemic conceptual framework, we examined the co-occurrence of Substance Abuse, Violence, and AIDS/HIV (i.e., SAVA), which are three adversities that uniquely affect racial/ethnic minorities, individuals living in poverty, and people in urban communities. We assessed the relationship between SAVA adversities and depressive symptoms among mothers living with HIV, as well as the moderating effect of resilience on this relationship. Participants included 55 mothers (M_age= 41.24, SD = 9.01; 81% Black) living with HIV in the U.S. MidSouth. Mothers were recruited from community agencies serving individuals living with HIV and completed hour-long interviews about SAVA, depression, resilience, life stressors, and their child’s mental health. Analyses were conducted in PROCESS for SPSS to test the relationship between SAVA and depression, as moderated by resilience. Analyses controlled for the influence of child maladaptive functioning (given known associations with maternal mental health) and maternal life stressors (given established associations with depressive symptoms). Findings indicated that experiencing more than one SAVA variable was associated with greater depressive symptoms (p < .05). Higher resilience was associated with lower depressive symptoms (r = −.45; p < .01). Moderation was supported (β = −.80; p < .01) as the relationship between more SAVA epidemics and higher depressive symptoms was stronger when resilience was low and weaker when resilience was high. Results not only highlight how co-occurring adversities exacerbate depressive symptoms, but also underscore the role of resilience as a key protective factor among mothers living with HIV. Resilience could therefore be a target of strengths-based treatment to reduce the negative effects of SAVA on depressive symptoms among mothers.

KEYWORDS:

• Domestic violence
• substance use
• AIDS
• resilient functioning
• women

Acknowledgments

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

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the University of Memphis Diversity Research Grant and the University of Memphis Faculty Research Grant Fund. This support does not necessarily imply endorsement by the University of Memphis of the study’s research conclusions. Authors effort on this study was also funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant number R15HD089410 (PI: Howell)].