Date of Conferral

8-6-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Kaye Reynolds

Abstract

High-risk HIV behavior remains a critical public health concern in the United States, particularly among socioeconomically and psychologically vulnerable populations. Despite extensive prevention efforts, a gap persists in understanding how structural and mental health factors jointly contribute to HIV risk. This study addresses that gap by examining the association between socioeconomic status (SES), including income, education, employment, and healthcare access, and mental health status (diagnosis of depression and days of poor mental health) on high-risk HIV behavior at the individual level. Guided by the social determinants of health (SDOH) theoretical framework, the study utilized secondary data for over 40,000 adults aged 18 and older who completed the 2022 BFRSS survey and provided complete responses to variables related to education, income, employment, healthcare access, mental health status (diagnosis of depression and days of poor mental health), high-risk HIV behavior, age, race and gender. Binary logistic regression was used to evaluate associations. For participants with limited healthcare access, the effect of depression on high-risk HIV behavior was stronger for males, indicating an intensified relationship between poor mental health and risky behavior. Similarly, the association between unemployment and high-risk HIV behavior was more pronounced among Black individuals, suggesting that race moderated the effect in a direction that increased vulnerability within this subgroup This study advances understanding of how intersecting structural and psychological factors contribute to HIV risk and supports implications for positive social change and prevention strategies for marginalized populations, expanded mental health support, and more equitable healthcare delivery models.

Download

Share

 
COinS