(provided by the applicant): The HIV contraction rate for Latina women in the U.S. is six times the rate for non-Latina, White women. Latinas are suffering disparate negative consequences from substance use disorders, including intimate partner violence, incarceration, homelessness, and medical ailments. Our long-term goal is to reduce the incidence of HIV and substance abuse related health disparities among Latinas. The objective of this application, which is a significant step in pursuit of this goal, is to determine how substance use (both licit and illicit) and HIV risk behavior trajectories of a community-based sample of Latina mothers and daughters are influenced by changes in familial mechanisms (mother-daughter acoplamiento or attachment), cultural processes, and other social determinants of substance abuse and HIV risk behaviors over time. The study design involves four waves of data collection. Baseline data were collected in a cross-sectional pilot study of intergenerational drug use and HIV risk behaviors among Latina mothers and daughters funded by NIDA (R24DA014260, PI: Mario De La Rosa, Ph.D.). Three new longitudinal assessments are proposed to follow-up on baseline assessment. The first new follow-up assessment will be spaced approximately 5 years from the original study's baseline assessment. The remaining two follow-up assessments will occur 1 year from the preceding follow-up assessment.
Our first aim i s to determine the influence of cultural and social determinants on trajectories of change for substance use and HIV risk behaviors among a community-based sample of Latina mothers and daughters. The working hypothesis is that Latina mothers and daughters who experience (1) more acculturation to U.S. culture;(2) poorer socioeconomic conditions;(3) a loss of interpersonal supports;(4) less religious involvement;(5) involvement with the criminal justice system;(6) intimate partner violence;(7) greater employment, relationship, and/or residential related chronic stress;or (8) declining mental health and medical status since their baseline assessment will exhibit either an increase in or maintenance of high rates of substance use and HIV risk behaviors over the 7 year assessment time period.
Our second aim i s to determine the influence of mother-daughter attachment on trajectories of change for substance use and HIV risk behaviors. Latina mothers and daughters who either increase their levels of attachment or maintain consistently high levels of attachment will report reduced or consistently lower levels of substance use and HIV risk behaviors over a 7 year time period.
Our third aim i s to determine the moderating role of mother-daughter attachment on associations between experiences of detrimental social determinants and trajectories of change for substance use and HIV risk behaviors.
Relevance to public health: This study will fundamentally advance culturally and empirically based substance abuse and HIV/AIDS prevention strategies for adult Latinas in the U.S. The lack of such strategies is a major public health problem because, until they become available, it is likely that there will be little if any reduction in the HIV/AIDS and substance abuse health disparities affecting Latinas. In the worst-case analysis, there could even be significant increases in substance use problems and HIV/AIDS cases in the U.S., given that Latinos are the largest and fastest growing minority group in the U.S.
|Cohen, David; Dillon, Frank R; Gladwin, Hugh et al. (2013) American parents' willingness to prescribe psychoactive drugs to children: a test of cultural mediators. Soc Psychiatry Psychiatr Epidemiol 48:1873-87|