"Will you need this health at all? Will you be alive?": using the bioecological model of mass trauma to understand HIV care experiences during the war in Ukraine.

INTRODUCTION: Russia's invasion of Ukraine in February 2022 has severely impacted the healthcare system, including the provision of HIV care. The ongoing war is a human-caused mass trauma, a severe ecological and psychosocial disruption that greatly exceeds the coping capacity of the community. The bioecological model of mass trauma builds on Bronfenbrenner's concept of interaction between nested systems to argue that social context determines the impact of life events on the individual and how an individual responds. This paper uses the bioecological model of mass trauma to explore the impact of Russia's aggression against Ukraine and the ongoing war on HIV-positive people who use drugs in Ukraine, a particularly vulnerable population that may be negatively affected by disruptions to social networks, healthcare infrastructure and economic conditions caused by mass trauma. METHODS: Data were collected between September and November 2022. A convenience sample of 18 HIV-positive people who use drugs were recruited from community organizations that work with people living with HIV, drug treatment programmes, and HIV clinics through direct recruitment and participant referral. A total of nine men and nine women were recruited; the age ranged from 33 to 62 years old (mean = 46.44). Participants completed a single interview that explored how the war had affected their daily lives and access to HIV care and other medical services; their relationships with healthcare providers and social workers; and medication access, supply and adherence. Data were analysed using the Framework Method for thematic analysis. RESULTS: The war had a profound impact on the social, emotional and financial support networks of participants. Changes in social networks, coupled with limited job opportunities and rising prices, intensified financial difficulties for participants. Relocating to different regions of Ukraine, staying at somebody else's home, and losing connections with social workers impacted medication adherence and created lengthy treatment gaps. Participants also experienced a decreased supply of antiretroviral therapy, concerns about accessing medication for opioid use disorder, and overwhelming fears associated with the war, which overshadowed their HIV-related health concerns and negatively impacted medication adherence. CONCLUSIONS: Our analysis reveals the complex impact of war on social networks and healthcare access. Maintaining support networks and competent healthcare providers will be essential amid the ongoing war.

Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students.

Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.

Parenting practices, bullying perpetration, and conduct problems among Ukrainian children.

BACKGROUND: Positive and consistent parenting practices are associated with the positive mental health of children. However, little is understood about the implications of the Russian military invasion on family dynamics in Ukraine. OBJECTIVE: This research aims to estimate the prevalence of childhood conduct disorder (CD) and bullying perpetration and their association with parenting practices among Ukrainian children living in proximity to the war. PARTICIPANTS AND SETTING: The sample included 2763 Ukrainian children ranging in age from 10 to 17 years (M = 12.6, SD = 1.23), 56.23 % girls. Children attended public secondary schools in Eastern Ukraine, mostly in Kharkiv and Kharkiv oblasts (regions). METHODS: Children reported on sociodemographic characteristics, parenting practices, CD, and bullying perpetration using smartphones, computers, or tablets, at home or in school IT classrooms. Data were collected on a secure online platform. RESULTS: Children reported teasing (23.68 %), spreading rumors (24.51 %), helping to harass (17.31 %), threatening to hurt or hit (21.65 %) other students, breaking rules (28.13 %), getting in fights (17.13 %), cheating (43.16 %), and being spanked by parents (30 %). Also, 1.83 % of girls and 3.43 % of boys met a borderline cutoff for CD. Lack of parent involvement was associated with increased CD and bullying risks. Poor parent monitoring, inconsistent discipline, and corporal punishment were associated with increasaed CD but not with bullying. CD mediated the association of poor monitoring, inconsistent discipline, and corporal punishment with bullying. CONCLUSION: Parental involvement, monitoring, consistent discipline, and avoidance of physical punishments are important practices that can reduce disruptive behavior and aggressive tendencies among Ukrainian children affected by the Russian war.

Bullying Victimization and Suicidal Thoughts: Emotional Distress and Neighborhood Conditions.

The study aims to examine (1) the association between bullying victimization and suicidal thoughts and (2) neighborhood conditions as a moderated mediated model of the association between bullying victimization, emotional distress, and suicidal thoughts. The sample consists of 414 African American youths (ages 12-17) in Chicago's Southside neighborhoods. Variables included suicidal thoughts, bullying victimization, emotional distress, neighborhood conditions, age, sex, and government assistance. Analyses included descriptive statistics, bivariate correlations, and multivariate regression analyses. The study found that bullying victimization was not directly associated with suicidal thoughts. However, bullying victimization was positively associated with emotional distress, which was related to suicidal thoughts. Moreover, emotional distress as a mediator of the association between bullying victimization and suicidal thoughts was observed when neighborhood conditions were a moderator. The findings suggest that bullying victimization and suicidal thoughts are major concerns for African American adolescents, and prevention and intervention need to be cost-effective.