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Evaluation of HIV-risk behaviors of Puerto Rican women with severe mental illness in Cuyahoga County, Ohio

Heaphy, Emily Lenore Goldman
http://rave.ohiolink.edu/etdc/view?acc_num=case1238002659

Abstract Details

2009, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
Background: Latinos in the United States are at high risk for depression, anxiety, and substance abuse and HIV/AIDS has excessively impacted this community. Individuals with severe mental illness (SMI) are more likely to engage in HIV high-risk behaviors. A range of psychiatric and social factors have been considered as correlates of sexual risk behavior with findings indicating a need for future studies to provide insight into the direction and nature of these associations. Objective: To describe the HIV-risk behaviors of Puerto Rican women with SMI in Cuyahoga County, Ohio using quantitative and qualitative techniques. Aim 1 investigated the association of childhood sexual abuse (CSA) and adult HIV-risk behaviors using a retrospective cohort design. The second aim examined psychiatric and social correlates of HIV sexual risk behavior and aim 3 compared data obtained qualitatively to data obtained quantitatively using criterion validity. Methods: The study sample consisted of 53 Puerto Rican women with SMI recruited between October 2002 and December 2005. Consenting participants participated in a baseline interview, two follow-up, semi-structured interviews, and up to 100 hours of non-continuous participant observation. Descriptive, bivariate, and multivariate analyses were conducted to describe HIV-risk behaviors and assess the efficacy of two data collection methods. Results: The relationship between CSA and HIV-risk may be mediated by partner abuse and mental illness diagnosis. Psychiatric and social factors were differentially associated with sexual risk behaviors and multivariate analysis showed that increased severity of psychiatric symptoms and factors and living below the poverty line are predictive of sexual risk behaviors. The correlations between quantitative and qualitative responses concerning sexual and drug use behaviors revealed agreement in some cases and inconsistencies and contradictions in others. Conclusions: Puerto Rican women with SMI are in need of targeted interventions that simultaneously address substance, childhood, and partner abuse, specific symptomatology, and the indirect effects associated with SMI such as living in poverty. A comparison of qualitative and quantitative methods revealed that inconsistent and contradictory responses are not uncommon and that a mixed-method design may provide a more complete way of obtaining HIV-risk behavior data of a sensitive nature.
Sana Loue (Committee Chair)
Martha Sajatovic (Committee Member)
Leslie Heinberg (Committee Member)
Daniel Tisch (Committee Member)
Epidemiology
HIV-RISK; HIV; SMI; HIV-RISK BEHAVIORS; sexual; abuse; CSA

Recommended Citations

Citations

  • Heaphy, E. L. G. (2009). Evaluation of HIV-risk behaviors of Puerto Rican women with severe mental illness in Cuyahoga County, Ohio [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1238002659

    APA Style (7th edition)

  • Heaphy, Emily. Evaluation of HIV-risk behaviors of Puerto Rican women with severe mental illness in Cuyahoga County, Ohio. 2009. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1238002659.

    MLA Style (8th edition)

  • Heaphy, Emily. "Evaluation of HIV-risk behaviors of Puerto Rican women with severe mental illness in Cuyahoga County, Ohio." Doctoral dissertation, Case Western Reserve University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1238002659

    Chicago Manual of Style (17th edition)

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© 2009, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.