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The Syndemic Effect of Injection Drug Use, Intimate Partner Violence, and HIV on Mental Health Among Drug-Involved Women in Kazakhstan

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Abstract

We examined the synergistic effect of substance use (injection drug use), intimate partner violence, and HIV (dubbed the “SAVA syndemic”) on depression and suicidal thoughts among a sample of high-risk women in Kazakhstan, a country with a notably high prevalence of suicide and violence against women and concentrated epidemics of HIV and injection drug use. Using baseline data from an intervention study conducted in Almaty, Kazakhstan among 364 drug-involved couples, multivariate logistic regression analyses were used to examine the relationship between the SAVA syndemic continuum and mental health. Compared to women reporting none of the SAVA conditions, women who experienced the full range of the SAVA syndemic continuum had a 15.5-fold odds (p < .05) of reporting depression and a 6-fold odds (p < .05) in reporting suicidal thought disturbances. Findings suggest the need for integrated screening assessments among practitioners and interventions designed to address multiple, commonly co-occurring conditions in Central Asia.

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Acknowledgements

Dr. Jiwatram-Negrón acknowledges the partial support received as a postdoctoral research fellow at the Vivian A. and James L. Curtis School of Social Work Research and Training Center at the University of Michigan.

Funding

This study was funded by the National Institute on Drug Abuse (NIDA R01-DA022914-01A2), awarded to Dr. Nabila El-Bassel.

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Correspondence to Tina Jiwatram-Negrón.

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All study procedures were reviewed and approved by the Columbia University and the Kazakhstan School of Public Health Institutional Review Boards.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Jiwatram-Negrón, T., Michalopoulos, L.M. & El-Bassel, N. The Syndemic Effect of Injection Drug Use, Intimate Partner Violence, and HIV on Mental Health Among Drug-Involved Women in Kazakhstan. Glob Soc Welf 5, 71–81 (2018). https://doi.org/10.1007/s40609-018-0112-1

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  • DOI: https://doi.org/10.1007/s40609-018-0112-1

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