The Role of Social Capital in African Americans' Attempts to Reduce and Quit Cocaine Use

BACKGROUND:

Research examining substance users' recovery has focused on individual-level outcomes while paying limited attention to the contexts within which individuals are embedded, and the social processes involved in recovery.

OBJECTIVES:

This paper examines factors underlying African American cocaine users' decisions to reduce or quit cocaine use and uses practice theory to understand how lifestyle changes and shifts in social networks facilitate access to the capital needed to change cocaine use patterns.

METHODS:

The study, an in-depth analysis of substance-use life history interviews carried out from 2010 to 2012, included 51 currently not-in-treatment African American cocaine users in the Arkansas Mississippi Delta region. A blended inductive and deductive approach to data analysis was used to examine the socio-cultural and economic processes shaping cocaine use and recovery.

RESULTS:

The majority of participants reported at least one lifetime attempt to reduce or quit cocaine use; motivations to reduce use or quit included desires to meet social role expectations, being tired of using, and incarceration. Abstinence-supporting networks, participation in conventional activities, and religious and spiritual practices afforded access to capital, facilitating cocaine use reduction and sobriety.

CONCLUSIONS:

Interventions designed to increase connection to and support from nondrug using family and friends with access to recovery capital (e.g., employment, faith community, and education) might be ideal methods to reduce substance use among minorities in low-income, resource-poor communities.

Purchase full article at:   http://goo.gl/tu8pcE

By:  Cheney AM¹, Booth BM², Borders TF³, Curran GM⁴.

¹ Center for Healthy Communities , University of California Riverside , Riverside , California , USA.

² Division of Health Services Research , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

³ Department of Health Management and Policy , University of Kentucky , Lexington , Kentucky , USA.

⁴ Department of Pharmacy Practice , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

Subst Use Misuse. 2016 Apr 20:1-11.

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A Multilevel Understanding of HIV/AIDS Disease Burden among African American Women

Disproportionate HIV/AIDS rates among African American women have been examined extensively—primarily from an individually-centered focus. Beyond individual behaviors, factors such as the hyper-incarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. This paper proposes a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities.

…Limited educational attainment, poverty, and imbalanced male-female sex ratios all fuel the HIV epidemic among African American populations (Dean & Fenton, 2010). Thus, structural interventions should continue to be incorporated in our HIV prevention dialogue, especially since they have proven to be efficacious (Adimora & Auerbach, 2010). Similar to others, this author argues that HIV is an individual, social and structural concern, requiring community engagement and mobilization toward its eradication. Although a universal “test-and-treat” model could potentially eliminate new HIV infections over time, social and structural barriers exist to widespread implementation and sustainability (Kulkarni, Shah, Sarma, & Mahajan, 2013). Neither a biomedical nor behavioral approach to HIV prevention can be sustained in the absence of considering the broader contexts. It is important to note, however, that there are substantial challenges associated with the implementation of structural interventions so as not to minimize the arduous nature in which they are executed (Auerbach et al., 2011). This becomes particularly difficult when opposing entrenched systems and interests that continue to marginalize and oppress certain groups (Miller, Reed, Francisco, & Ellen, 2012), such as African American women…

Below:  A Conceptual Model (with Presumed Pathways [P_x]) for Understanding Geobehavioral Vulnerability to HIV among African Americans

Full article at:   http://goo.gl/hIrFc9

By:  Bridgette M. Brawner, PhD, APRN, Assistant Professor of Nursing

Bridgette M. Brawner, Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., 4th Floor, Room 419, Philadelphia, PA 19104-4217, 215-898-0715 (office), 215-746-3374 (fax),

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Understanding HIV Risk Behavior among Tuberculosis Patients with Alcohol Use Disorders in Tomsk, Russian Federation

Russian Federation’s (RF) HIV epidemic is the fastest growing of any country. This study explores factors associated with high HIV risk behavior in tuberculosis (TB) patients with alcohol use disorders in Tomsk, RF. 

This analysis was nested within the Integrated Management of Physician-delivered Alcohol Care for TB Patients (IMPACT, trial number NCT00675961) randomized controlled study of integrating alcohol treatment into TB treatment in Tomsk. Demographics, HIV risk behavior (defined as participant report of high-risk intravenous drug use and/or multiple sexual partners with inconsistent condom use in the last six months), clinical data, alcohol use, depression and psychosocial factors were collected from 196 participants (161 male and 35 female) at baseline. 

Forty-six participants (23.5%) endorsed HIV risk behavior at baseline. Incarceration history, age under 41, drug addiction, history of a sexually transmitted disease (STD), low social capital and heavier alcohol use were significantly more likely to be associated with HIV risk behavior at baseline. In adjusted analysis, age under 41, incarceration history and STD history (OR: 3.48, CI: 1.5, 8.10) continued to be significantly associated with HIV risk behavior. 

Understanding HIV transmission dynamics in Russia remains an urgent priority to inform strategies to address the epidemic. Larger studies addressing sex differences in risks and barriers to protective behavior are needed.

Below:  Substance use and HIV risk characteristics of study participants, by sex

Full article at:   http://goo.gl/B9iCmD

By:  

Ann C. Miller, Sonya S. Shin

Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America

A. Katrina Nelson, Sidney Atwood, Charmaine S. Lastimoso, Sonya S. Shin

Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America

Viktoria Livchits

Partners In Health Representative Office in Russian Federation, Moscow, Russia

Shelly F. Greenfield, Hilary S. Connery

Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA United States of America

Shelly F. Greenfield, Hilary S. Connery

Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America

Shelly F. Greenfield

Division of Women's Mental Health, McLean Hospital, Belmont, MA, United States of America

Galina Yanova, Sergei Yanov

Tomsk Oblast Tuberculosis Hospital, Tomsk, Russian Federation

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Social Capital, Substance Use Disorder & Depression among Youths

BACKGROUND:

Social capital - the network of social connections that exists among people - is known to be related to depression and substance use among adults. However, little is known about these relationships among adolescents, even though this age group is vulnerable due to factors of peer pressure, family, neighborhood, and maturational changes.

OBJECTIVES:

To evaluate the associations among social capital, substance use disorder and depression on a sample of 17 705 respondents between the ages of 12 and 17 in the 2009 National Survey of Drug Use and Health.

METHODS:

Structural equation modeling was used to examine social capital; responses to 48 items differentiated into two factors that measured structural social and cognitive social capital. Adolescent depression and substance use disorder were measured as past-year major depressive episodes and substance use disorder according to DSM-IV criteria.

RESULTS:

Structural social capital was associated with substance use disorder and depression. Cognitive social capital was associated with substance use disorder, but not with depression. Substance use disorder mediated the association between structural and cognitive social capital and depression.

CONCLUSION:

There was support for associations among youth structural and cognitive social capital, substance use disorder and depression. These findings suggest that additional research of a longitudinal nature is needed to determine causal connections among social capital, depression and substance use disorder for adolescents.

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By:  Awgu E1, Magura S2, Coryn C2.

• 1 Institutional Research , Loyola University Maryland , Baltimore , MD , USA.
• 2 The Evaluation Center , Western Michigan University , Kalamazoo , MI , USA. 
• Am J Drug Alcohol Abuse. 2016 Jan 25:1-9.

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Theoretical Framework of Social Capital and HIV-Related Risk among Female Sex Workers in Swaziland

Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. 

This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing and using condoms with non-paying partners, and was inversely associated with reported verbal or physical harassment as a result of selling sex. 

Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

Full article at:   http://goo.gl/mf4hP1

By:   Virginia A. Fonner,1,* Deanna Kerrigan,2 Zandile Mnisi,3 Sosthenes Ketende,4 Caitlin E. Kennedy,1 and Stefan Baral4

¹Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland, United States of America

²Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, Maryland, United States of America

³Swaziland National AIDS Program, Mbabane, Swaziland

⁴Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, United States of America

Institut Pluridisciplinaire Hubert Curien, France

* E-mail: ude.hpshj@wordetv

 

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Social and Recovery Capital amongst Homeless Hostel Residents Who Use Drugs and Alcohol

BACKGROUND:

Homeless people who use drugs and alcohol have been described as one of the most marginalised groups in society. In this paper, we explore the relationships of homeless drug and alcohol users who live in hostels in order to ascertain the nature and extent of their social and recovery capital.

METHODS:

Data were collected during 2013 and 2014 from three hostels. Each hostel was in a different English city and varied in size and organisational structure. Semi-structured interviews were conducted with 30 residents (21 men; 9 women) who self-reported current drink and/or drug problems. Follow-up interviews were completed after 4-6 weeks with 22 residents (16 men; 6 women). Audio recordings of all interviews were transcribed verbatim, systematically coded and analysed using Framework.

RESULTS:

Participants' main relationships involved family members, professionals, other hostel residents, friends outside of hostels, current and former partners, and enemies. Social networks were relatively small, but based on diverse forms of, often reciprocal, practical and emotional support, encompassing protection, companionship, and love. The extent to which participants' contacts provided a stable source of social capital over time was, nonetheless, uncertain. Hostel residents who used drugs and alcohol welcomed and valued interaction with, and assistance from, hostel staff; women appeared to have larger social networks than men; and hostels varied in the level of enmity between residents and antipathy towards staff.

CONCLUSION:

Homeless hostel residents who use drugs and alcohol have various opportunities for building social capital that can in turn foster recovery capital. Therapies that focus on promoting positive social networks amongst people experiencing addiction seem to offer a valuable way of working with homeless hostel residents who use drugs and alcohol. Gains are, however, likely to be maximised where hostel management and staff are supportive of, and actively engage with, therapy delivery

Full article at:  http://goo.gl/Y1dYL1

By:  Neale J1, Stevenson C2.

• 1Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, London SE5 8AF, UK; Centre for Social Research in Health, University of New South Wales, Sydney, NSW 2052, Australia.
• 2Department of Psychology, Social Work and Public Health, Oxford Brookes University, Jack Straws Lane, Marston, Oxford OX3 0FL, UK. Electronic address: cstevenson@brookes.ac.uk. 

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Social Capital Role in Managing High Risk Behavior: a Narrative Review (Iran)

Social capital as a social context based concept is a new component in addition to the previous factors including the biologic–environmental, the genetic and the individual behavior factors that influence health and society. Social capital refers to the information that makes people believe being interesting & being paid attention to, & respected, valued, and belonging to a network of bilateral relations. Health issue is greatly affected by the existence of social capital. High risk behaviors refer to the ones enhancing the probability of negative and devastating physical, psychological and social consequences for an individual. Negative & overwhelming results mean keeping one’s distance from social norms as a result rejection and labeling (social stigma) and finally, to distance oneself from the benefits of social life in the individuals with high risk behaviors. The present study reviews social capital in the groups having high risk behaviors.

Article review results led to organizing the subjects into 6 general categories: Social capital and its role in health; Social capital in groups with high risk behaviors (Including: substance abusers, AIDS patients, the homeless and multi-partner women); Social capital in different social groups; measurement tools for social capital and risk behaviors; the role of health in helping people with risky behaviors with the focus on improving social capital and social support. The findings of this study indicate that social capital was significantly lower in the substance abusers than the non-addicts. Also, social participation, social trust and networks of social relationships were significantly lower than non-drug abusers. Social capital has interactive effects on risky behaviors and delinquency. On the one hand, high levels of social capital can be involved in preventing delinquency. On the other hand, creating negative social capital in high risk groups is also considered as the damaging effects of the negative aspects of social capital in these groups.

From this review extracted findings, it can be concluded that to design risky behaviors programs and preventive interventions, social capital and social support should be considered more than before. To accept an addict or HIV sufferer is effective in reducing their psychological reactions. So with effective social interaction and social support, these people can improve their risky lifestyles. As a result, these changes are associated with higher levels of satisfaction with their lives. Finally, it is recommended to design and implement counseling programs in order to educate health-promoting behaviors in high risk groups focusing on social capital and social support.

Full article at: http://goo.gl/fiOzuc

By: Mansoure Afzali,1,2 Zohreh Shahhosseini,3 and Zeinab Hamzeghardeshi3,4

¹Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran

²Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

³Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran

⁴Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran

Corresponding author: Zeinab Hamzehgardeshi, Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery faculty, Mazandaran University of Medical Sciences, Sari, Iran, Vesal Street, Amir Mazandarani Boulevard, Sari, Mazandaran Province, Iran. Po Box: 4816715793, Office Tel: +98 11 33367342-5, Fax: +98 11 33368915. E-mail: ri.ca.smut.izar@hezmah

   

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Acceptance of Sexual Minorities, Discrimination, Social Capital and Health and Well-Being: A Cross-European Study among Members of Same-Sex and Opposite-Sex Couples

Below:  Multilevel structural equation model with self-rated health as dependent variable. Solid lines represent significant relationships with standardized β coefficients; Interrupted lines represent non-significant relationships with standardized β coefficients and p values. *P value is smaller than or equal to 0.05; **P value is smaller than or equal to 0.01; ***P value is smaller than or equal to 0.001

Below:  Multilevel structural equation model with subjective well-being as dependent variable. Solid lines represent significant relationships with standardized β coefficients; Interrupted lines represent non-significant relationships with standardized β coefficients and p values. *P value is smaller than or equal to 0.05; **P value is smaller than or equal to 0.01; ***P value is smaller than or equal to 0.001

LGB acceptance was significantly related to better self-rated health and subjective well-being among all individuals, and these associations were partially mediated by individual social capital. No differences in these associations were found between individuals living in same-sex and opposite-sex couples. Sexuality-based discrimination had an additional significantly negative effect on self-related health and subjective well-being.

The findings of this study suggest a negative association between exposure to discrimination based on sexual orientation and both health and well-being of individuals living in same-sex couples. Members of same-sex couples and opposite-sex couples alike may benefit from living in societies with a high level of LGB acceptance to promote better health and well-being.

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