1 / 37

Patria Rojas, Ph.D., M.P.H., M.S.W. Frank R. Dillon, Ph.D .

Adult Latina Drug Use & HIV Risks : Clinical Implications from an Intergenerational Study of Mothers & Daughters. Patria Rojas, Ph.D., M.P.H., M.S.W. Frank R. Dillon, Ph.D . Center for Research for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD)

calida
Download Presentation

Patria Rojas, Ph.D., M.P.H., M.S.W. Frank R. Dillon, Ph.D .

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Adult Latina Drug Use & HIV Risks:Clinical Implications from an Intergenerational Study of Mothers & Daughters Patria Rojas, Ph.D., M.P.H., M.S.W. Frank R. Dillon, Ph.D. Center for Research for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) Florida International University Prepared for: C-SALUD Bi-Annual conference, April 26, 2011 ACKNOWLEDGEMENTSThis study was supported by award number P20MD002288 from the National Institute on Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Minority Health and Health Disparities, or the National Institutes of Health .

  2. Road Map • Why Study Adult Latina Mother-Daughter Drug use and HIV/AIDS risk? • Overview of Study Methods and Sample • Main Findings • Questions and Discussion • How do study findings inform clinical services for Latina women in Miami Dade county? • Your recommendations for integrating findings with community practice?

  3. Background The Women’s Study • Primary Study of The Latino Minority Drug Abuse Research Program (NIDA R24DA14260, Dr. Mario De La Rosa, PI) • Foundation for Ongoing Longitudinal Study - Trajectories of Drug Abuse and HIV Risk among Latina Mother-Daughter Dyads(NINR R01NR012150).

  4. Why Study Adult Latina Mother-Daughter Drug use & HIV/AIDS risk? • HIV/AIDS & Drug Abuse among Latinas in the U.S. • Escalating health disparities • Nationally, the rate of infection among Latina women is nearly four times that of non-Latina White women (CDC, 2010). • HIV/AIDS is the 3rd leading cause of death among Latina women in Florida age 25 - 44 years (Florida Department of Health-FDOH, 2011).

  5. Why Study Adult Latina Mother-Daughter Drug use & HIV/AIDS risk? • Latino illicit drug use rates have increased steadily since 2002 [Substance Abuse and Mental Health Services Administration (SAMHSA), 2008]. • Latina adults also experience disparate negative consequences from drug use disorders (Amaro et al., 2006) • Intimate partner violence • Incarceration • Homelessness • Medical problems

  6. Why Study Adult Latina Mother-Daughter Drug use & HIV/AIDS risk? • Adult Latinas in the U.S. • A vulnerable & understudied population in the drug abuse and HIV/AIDS prevention fields (Volkow, 2006). • Risk & protective processes determining drug use & HIV risk behaviors of adult Latinas remain relatively unknown (Canino, 2004). • The Women’s Study • Aims to better understand potential risk & protective processes by studying adult Latina mother-daughter dyads

  7. What is Attachment? Attachment • A consistent emotional bond that an individual experiences toward significant others such as family, friends, and other important people in his or her life (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1969/1982, 1973). • Secure attachment to parents, friends, and others in adolescents and adults is associated with psychological adjustment, school achievement, and self-esteem (Armsden & Greenberg, 1987; Buhrmester, 1990; Bukowski, Hoza, Boivin, 1993; Hartup, 1996; Nickerson & Nagle, 2004).

  8. The Importance of Latina Mother-Daughter Attachment • Latina Mother-Daughter Attachment • Armsden & Greenberg (1987) conceptualized attachment beyond childhood (across all stages of development) to consist of: • Mutualtrust of others • Communication with others • Closeness to others • The Women’s Study was also guided by the Bogenschneider (1996) ecological risk / protective model • A theoretical perspective that emphasizes family relations as the primary context for human development across the lifespan

  9. The Importance of Latina Mother-Daughter Attachment • Supportive parent-child relations play a powerful positive role in the lives of Latinos (De La Rosa & White, 2001; Gonzalez Castro et al., 2007). • E.g., Healthy family cohesion or familismo is associated with Latina/o adult functioning and wellness across the lifespan (Gil, 1996; Gil & Vega, 1996; Vega, Kolody, & Valle, 1986; Rivera et al., 2008). • We expected that mother-daughter attachment would be inversely linked to drug abuse and HIV risk behaviors among Latina mothers and their daughters.

  10. Overview of Study Methods and Sample

  11. Methods • Data collected from drug abusing and non-abusing mother-daughter dyads in Miami-Dade via interviews from 2002-2005. • Criteria for mothers & daughters to be included into community-based study: • consenting to be interviewed for at least 2-3 hours • 18 years old or older • self-identifying as Latina • living in Miami-Dade County, Fl.

  12. Methods • Participants recruited via snowball sampling method (chain referral; McCracken et al., 1987) • Non-drug abusing Latinas: • community health fairs, health clinics, radio announcements on local Spanish-language stations, and advertisements on local television channels • Drug abusing Latinas: • substance abuse support groups such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) meetings and by advertising in a local alternative newspaper, FM radio station, and announcements posted at local drug court program

  13. Methods • All measures were pilot-tested to ensure cultural and linguistic sensitivity to Latino culture and to women • Interviews were conducted in either Spanish (65%) or English (35%) by trained women interviewers using a structured questionnaire • The interview took 2-3 hours to complete, and took place at locations convenient to participants. • 69% at home • 19% at university’s offices • 12% other places (work, public places)

  14. Methods • 316 mothers & daughters were interviewed • On average, mothers were 52 years old (range of 33-88), daughters were 28 years old (range of 18-48) • Each participant was classified as a non-substance abuser or substance abuser based on the following criteria: • Alcohol abuser: at least 4-5 glasses of wine, 3-4 cans/bottles of beer, or 3-4 four-ounce drinks of hard liquor per occasion-during the 12 months prior to assessment (adapted from Naimi et al., 2003) • Illicit drug abuser: at least 3 days per week of marijuana use, 2 days per week of cocaine use, one or more occasions of heroin use per week, and/or least 3 ecstasy use occasions per month during the 12 months prior to assessment (adapted from Turner et al., 2001) • Abuse of prescribed medication: medicine use without a doctor’s authorization, in larger amounts than prescribed, or for longer periods than prescribed, in the 12 months prior to assessment (adapted from Turner et al., 2001)

  15. Methods • Mothers & daughters were classified into 4 types of dyads • Dyad 1: mother-daughter both drug or alcohol abusers (n=40) • Dyad 2: mother-abuser and daughter–non-abuser (n=19) • Dyad 3: mother-non-abuser and daughter-abuser (n=51) • Dyad 4: mother-daughter both non-abusers (n=48) • Total Dyads = 158

  16. Top Drugs of Abuse

  17. Differences in Age across Dyads

  18. Demographics: Nativity • Most mothers were immigrants (84%, n = 133) • Approximately half of daughters (54%, n = 86) were immigrants. DAUGHTERS

  19. Countries of Origin Across Dyads

  20. Demographics and Drug Abuse • Findings suggest that age and nativity (acculturation) are related to adult Latina drug abuse. • Additional age related finding • On average, the younger a drug abusing mother started using illicit drugs (M = 26.5 years), the younger her daughter reported starting using illicit drugs (M = 18.4 years).

  21. Demographics: Personal Income • Personal Income during past year • median = $5,000 to $9,999 • No significant difference across dyads

  22. Demographics: Education Level • Education Level • Median = “post-high school training” • No significant difference across dyads

  23. Demographics: Employment Status • Current Employment Status • No significant difference across dyads 51.6%

  24. Demographics: Others • Marital Status: • 41% of mothers married • 29% of daughters married • No significant difference across dyads • Separation from Mother • Approximately 18% of daughters were separated from mothers during development • A control variable

  25. Main Results Main Results

  26. Mother-Daughter Attachment & Drug Abuse (De La Rosa et al., 2010)

  27. Mother-Daughter Attachment & Drug Abuse (De La Rosa et al., 2010) • IMPLICATIONS: • Mother-daughter attachment & drug abuse findings emphasize the need for mother-daughter-based prevention/treatment efforts; especially with drug abusing mothers, to reduce potential intergenerational transmission of drug use disorders among Latina women.

  28. Mother-Daughter Attachment & HIV Risk Behaviors (De La Rosa et al., 2010) • Sex Under the Influence (SUI) • 61% of daughters engaged in SUI of alcohol during past year • 28% reported engaged in SUI of illicit drugs during past year

  29. Mother-Daughter Attachment & HIV Risk Behaviors (De La Rosa et al., 2010) • Sex under the Influence of Illicit Drugs (SUI-D) • Drug abusing daughters with a drug abusing mother (dyad 1) reported more SUI-D. • Daughters who reported less attachment reported more SUI-D.

  30. Mother-Daughter Attachment & HIV Risk Behaviors (De La Rosa et al., 2010) • Sex under the Influence of Alcohol (SUI-A) • Younger daughters reported more SUI-A. • Unmarried daughters(81%) reported more SUI-A. • Non-abusing daughters with non-abusing mothers (Dyad 4) reported less sex under the influence of alcohol than all other dyads.

  31. Mother-Daughter Attachment & HIV Risk Behaviors (De La Rosa et al., 2010) • IMPLICATIONS: • Attachment and SUI findings emphasize the need for mother-daughter-based prevention/treatment efforts; especially with drug abusing mothers, to reduce HIV risk behaviors among young Latina women.

  32. Age of Sexual Debut (Dillon et al., 2010; Rojas et al., 2010) • Averages among Daughters: • Vaginal Sex = 16 years • Oral Sex = 17 years • Anal Sex = 22 years • Daughters reported younger ages of sexual debut when they • spent more time in the U.S. (M= 65% of life) • experienced maternal drug abuse during development. • The younger daughters started having sex, the more likely they reported • Future drug abuse and HIV risk behaviors (greater number of sexual partners, sex under the influence) as adults. • IMPLICATIONS: These findings inform HIV/AIDS and drug abuse clinical services with Latina population in Miami-Dade County.

  33. Condom Use Among Latinas • 133 women engaged in vaginal sex and were told about HIV by their healthcare providers. • 75% of the participants used condoms sometimes • Reasons they did not use condoms in instances: • Wanted pregnancy • Condoms were not available • They were in a monogamous relationship and trusted partners. • Reasons women used condoms in instances: • They were with a new partner • To prevent STDs and HIV • Because they were available

  34. Condom Use Among Latinas

  35. Condom Use Among Latinas Reasons for using condoms all the time during vaginal sex

  36. Condom Use Among Latinas Implications: • Latinas associate condoms with distrust in a relationship or partner. • Latinas believe that being in a monogamous relationship means that they are not at risk of acquiring HIV or other STIs. • Married or women with a main partner were less likely to use condoms.

  37. Questions & Discussion • Implications of study findings for clinical services for Latina women in Miami Dade county? • Recommendations for integrating findings with community practice?

More Related