Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use

• Published in: AIDS and behavior 2024-03, Vol.28 (3), p.774-785
• Main Authors: Ramos, Stephen D., Vincent, Wilson, Siconolfi, Daniel E., Pollack, Lance M., Horvath, Keith J., Campbell, Chadwick K., Tebbetts, Scott, Kegeles, Susan M., Storholm, Erik D.
• Format: Article
• Language: English
• Subjects: Affect; Aggression; Alcohol abuse; Alcohol Drinking - epidemiology; Alcohol use; Alcohols; Anxiety; Domestic violence; Emotions; Gays & lesbians; Health Psychology; HIV; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infectious Diseases; Intimate Partner Violence; Male; Medicine; Medicine & Public Health; Mens health; Mental depression; Mood; Original Paper; Public Health; Risk Factors; Sexual and Gender Minorities; Sexually transmitted diseases; STD; Symptomology; Violence
• ISSN: 1090-7165; 1573-3254; 1573-3254
• DOI: 10.1007/s10461-023-04186-x

Young Black Sexual Minority Men with HIV (YBSMM+) in the US South encounter multiple socio-structural challenges that contribute to disproportionately poor HIV-related outcomes across the care continuum. Depression, anxiety, intimate partner violence (IPV), and alcohol use are prominent factors that negatively impact engagement with HIV care. Syndemic theory posits that these multiple factors interact synergistically to promote poor outcomes; however, depression itself is highly heterogeneous in presentation, which may pose issues when examining associations to HIV care engagement. This study sought to better understand the associations of specific depressive symptomology subtypes, generalized anxiety, experienced IPV, and alcohol use on HIV care engagement for YBSMM+. Results showed that interpersonally oriented depressive symptomatology was associated with increased HIV care engagement among YBSMM + who abstained from alcohol. On the other hand, among YBSMM + who frequently binge drank, combined negative affect and somatic components of depressive symptomatology and frequency of IPV experiences were associated with decreased HIV care engagement while generalized anxiety was associated with increased HIV care engagement. The findings suggest that the negative affect and somatic components of depression may be particularly salient for HIV care engagement among YBSMM + who binge drink frequently. Developing targeted interventions that address these specific conditions while accounting for the nuances of mood-based symptomatology could improve intervention efforts geared towards improving HIV care engagement among YBSMM+. Resumen Los jóvenes afroamericanos de minorías sexuales con VIH en el sur de Estados Unidos enfrentan diversos desafíos socioestructurales que contribuyen a resultados desfavorables, de manera desproporcionada, en lo que respecta a su atención médica relacionada con el VIH. La depresión, la ansiedad, la violencia en las relaciones íntimas, y el consumo de alcohol son factores destacados que afectan negativamente su involucramiento en el cuidado del VIH. La teoría sindémica sugiere que estos múltiples factores interactúan de manera sinérgica para promover resultados deficientes; sin embargo, la depresión, en sí misma, se presenta de manera muy variada, lo que puede plantear desafíos al examinar las conexiones con la atención médica del VIH. Este estudio tuvo como objetivo mejorar la comprensión de cómo los subtipos específicos de síntomas de