# Violence, substance use, sleep disturbances, and hypertension among women with HIV: A syndemic approach (VS2H2 Syndemic)

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $634,531

## Abstract

Project summary
 Women with HIV (WWH) are a high priority population that faces a clustering of gender-based
violence (GBV), substance use, mental health disorders, sleep disturbances, and hypertension (HTN).
Studies on the syndemic of substance use, violence, and HIV/AIDS (SAVA) have shown that these factors
are associated with mental health disorders and adverse HIV outcomes. However, the relationship of these
syndemic factors on noncommunicable diseases in this population is not well known. HTN and sleep
disturbances are common and co-occur among WWH. GBV, substance use, and mental health disorders are
associated with sleep disturbances and HTN, separately, but a holistic understanding of these syndemic
factors and co-morbid health outcomes is not well established, especially among WWH. A syndemic approach
would facilitate the investigation of the specific pathways by which these factors interact to exacerbate co-
morbid sleep disturbances and HTN. There is also increasing evidence about the important contribution of race
and income, as manifested in social and neighborhood context, to this syndemic cluster.
 The Women’s Interagency HIV Study (WIHS) is the largest ongoing prospective study of women at
risk for HIV and WWH in the US. Leveraging the resources of WIHS and building on previous SAVA-
related work, the objective of this proposal is to understand how syndemic factors longitudinally impact
sleep disturbances and HTN among WWH who are confronting distinct social, neighborhood, and
economic realities. We also seek to clarify the interaction, mediators, and directionality linking these multi-
level syndemic factors and co-morbid health outcomes. The specific aims of the proposed study are to: 1)
Assess how syndemic factors (i.e., gender-based violence, substance, and depression) interact in
longitudinally impacting co-morbid sleep disturbances/HTN among WWH; 2) Assess whether individual-
and neighborhood-level factors related to race and income impact syndemic factors and co-morbid sleep
disturbances/HTN; 3) Assess whether social network factors impact syndemic factors and co-morbid
sleep disturbances/HTN.
 Led by an early-stage investigator, this transdisciplinary team of investigators is comprised of content
and methodological experts relevant to the study. The results of the study will generate important insights for
policies as well as multi-sectoral interventions to alleviate social and health inequities among WWH both in the
US and worldwide.

## Key facts

- **NIH application ID:** 10889239
- **Project number:** 5R01HL160324-04
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Sahnah Lim
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $634,531
- **Award type:** 5
- **Project period:** 2021-09-15 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889239

## Citation

> US National Institutes of Health, RePORTER application 10889239, Violence, substance use, sleep disturbances, and hypertension among women with HIV: A syndemic approach (VS2H2 Syndemic) (5R01HL160324-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10889239. Licensed CC0.

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