Assessing the Nutritional Health Outcomes of African American Women with HIV and Substance Abuse Disorders Using a Socioecological Approach

Abstract

It is well established that poor nutritional status leaves HIV-positive substance abusers especially vulnerable to an increased risk of opportunistic infections and other illnesses. Socioecological frameworks have been useful for identifying multiple influences on health risks, leading to the development and evaluation of promising community-based interventions for diseases such as cancer and diabetes. This article presents a conceptual model, based on the socioecological approach, to examine the mechanisms and pathways by which the various contextual factors unique to HIV-positive African American women with substance abuse disorders intersect to impact their nutritional health outcomes. The mediating effects of the interpersonal, environmental, and psychological factors on the direct links between disease symptomology, demographic and socioeconomic variables, and nutritional health are emphasized. The long-term goal is to provide the empirical foundation necessary to design targeted interventions that meet the unique personal, social, and familial needs of this population with multiple vulnerabilities.

Comment on Project THANKS: Examining HIV/AIDS-Related Barriers and Facilitators to Care in African American Women: A Community Perspective

“…Studies show that managing HIV in addition to other chronic conditions can affect treatment adherence (taking multiple medications for multiple conditions), retention in care, exacerbate stress and depression, increase side effects, and lead to worse health outcomes. 10,12,13 In a series of focus groups conducted in Washington, DC, with HIV-positive African American women aged 52 to 65, comorbidities were perceived to be more difficult to self-manage than HIV. 12 Warren-Jeanpiere et al concluded that optimal HIV self-management (adhering to daily medication, eating well, exercising, doing something good for others and self, and engaging in spiritual activities) must be viewed within a larger context that addresses HIV and comorbidities concurrently.…”