Brooks Mohamad Adam, Rodwin Aaron H, Gwadz Marya, Wilton Leo, Serrano Samantha, Sherpa Dawa, Cleland Charles M, Munson Michelle R
Silver School of Social Work, New York University, 1 Washington Square N, New York, NY, USA.
State University of New York at Binghamton, Binghamton, NY, USA.
J Racial Ethn Health Disparities. 2025 May 7. doi: 10.1007/s40615-025-02458-x.
This paper examines depression, post-traumatic stress disorder (PTSD), and comorbid depression/PTSD among Black and Latinx young and emerging adults (YEA) living with HIV. We incorporated a social-ecological framework to examine risk factors associated with mental health conditions, comparing foreign and US-born groups.
We used a hybrid recruitment strategy and surveyed 271 Black and Latinx YEA (ages 19-28 years) living with HIV in the Eastern USA. We used multivariable logistic regressions and hypothesized certain individual, interpersonal, community/societal risk factors would be positively associated with depression, PTSD, and comorbid depression/PTSD.
Participants experienced elevated rates of depression (33.9%), PTSD (34.0%), and comorbid depression/PTSD (19.1%). Contrary to our hypothesis, US-born participants had significantly higher rates of mental health conditions compared to foreign-born participants. At the individual-level, foreign-born was associated with lower comorbid depression/PTSD [RRR 0.38 (95% CI 0.15, 0.97)], cisgender with lower comorbid depression/PTSD [RRR 0.42 (95% CI 0.18, 0.99)], greater number of Adverse Childhood Experiences with PTSD [OR 1.18 (95% CI 1.08, 1.29)], and comorbid depression/PTSD [RRR 1.28 (95% CI 1.12, 1.47)], while moderate/high substance use with depression [OR 2.30 (95% CI 1.01, 5.25)] and comorbid depression/PTSD [RRR 3.74 (95% CI 1.07, 13.03)]. At the interpersonal-level, lower social support was associated with higher depression [OR 0.99 (95% CI 0.97, 1.00)], PTSD [OR 0.98 (95% CI 0.97, 0.99)], and comorbid depression/PTSD [RRR 0.97 (95% CI 0.96, 0.99)]. At the community/societal-level, discrimination was associated with higher depression [OR 1.05 (95% CI 1.02, 1.08)] and comorbid depression/PTSD [RRR 1.07 (95% CI 1.02, 1.11)].
Understanding social-ecological risk factors associated with mental health conditions of Black and Latinx YEA living with HIV is important in determining potential avenues for targeted prevention and intervention to improve mental health.
本文研究感染艾滋病毒的黑人和拉丁裔青年及新兴成年人（YEA）中的抑郁症、创伤后应激障碍（PTSD）以及抑郁症/创伤后应激障碍共病情况。我们采用社会生态框架来研究与心理健康状况相关的风险因素，并比较在国外出生和在美国出生的群体。
我们采用混合招募策略，对美国东部271名感染艾滋病毒的黑人和拉丁裔青年及新兴成年人（年龄在19 - 28岁）进行了调查。我们使用多变量逻辑回归，并假设某些个体、人际、社区/社会风险因素会与抑郁症、创伤后应激障碍以及抑郁症/创伤后应激障碍共病呈正相关。
参与者中抑郁症（33.9%）、创伤后应激障碍（34.0%）以及抑郁症/创伤后应激障碍共病（19.1%）的发生率较高。与我们的假设相反，在美国出生的参与者心理健康状况发生率显著高于在国外出生的参与者。在个体层面，在国外出生与较低的抑郁症/创伤后应激障碍共病相关[相对风险比（RRR）0.38（95%置信区间0.15，0.97）]，顺性别与较低的抑郁症/创伤后应激障碍共病相关[RRR 0.42（95%置信区间0.18，0.99）]，童年不良经历数量较多与创伤后应激障碍[比值比（OR）1.18（95%置信区间1.08，1.29）]以及抑郁症/创伤后应激障碍共病[RRR 1.28（95%置信区间1.12，1.47）]相关，而中度/大量物质使用与抑郁症[OR 2.30（95%置信区间1.01，5.25）]以及抑郁症/创伤后应激障碍共病[RRR 3.74（95%置信区间1.07，13.03）]相关。在人际层面，较低的社会支持与较高的抑郁症[OR 0.99（95%置信区间0.97，1.00）]、创伤后应激障碍[OR 0.98（95%置信区间0.97，0.99）]以及抑郁症/创伤后应激障碍共病[RRR 0.97（95%置信区间0.96，0.99）]相关。在社区/社会层面，歧视与较高的抑郁症[OR 1.05（95%置信区间1.02，1.08）]以及抑郁症/创伤后应激障碍共病[RRR 1.07（95%置信区间1.02，1.11）]相关。
了解与感染艾滋病毒的黑人和拉丁裔青年及新兴成年人心理健康状况相关的社会生态风险因素，对于确定有针对性的预防和干预潜在途径以改善心理健康非常重要。
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