Maladaptive Coping Strategies Mediate the Relationship Between Depression and Anxiety and Moderate-to-Heavy Alcohol...

Young South Africans living with HIV experience high rates of depression and anxiety, which may contribute to poor HIV clinical outcomes by leading to moderate-to-heavy alcohol use. This analysis sought to examine whether maladaptive coping strategies mediated the relationship between depression and anxiety and moderate-to-heavy alcohol use in this population. This secondary analysis compared baseline data from two cohorts of young South Africans ages 18-24 from the Cape Town and East London. We performed a series of mediation analyses to determine the relationship among depression and anxiety, maladaptive coping, and moderate-to-heavy alcohol use. We found that higher levels of depressive (OR: 1.140, 95% CI: 1.054-1.234, p = 0.001, d = 0.072), but not anxiety (OR: 1.079, 95% CI: 0.987-1.180, p = 0.096, d = 0.042) was associated with moderate-to-heavy alcohol use. Negative emotion-focused coping was not a mediator of the relationship between depression and alcohol use, but avoidant coping was a significant partial mediator of the relationship between depressive symptoms and alcohol use (Indirect effect = 0.038, 95% CI: 0.010, 0.089). Both negative emotion-focused coping (Indirect effect = 0.049, 95% CI: 0.007, 0.116) and avoidant coping (Indirect effect = 0.046; 95% CI: 0.012, 0.115) were significant partial mediators of the relationship between anxiety symptoms and alcohol use. Our findings that avoidant coping and both avoidant and emotion-focused coping may mediate the relationships between depression and alcohol use and anxiety and alcohol use, respectively, may lend support to future interventions seeking to alter coping strategies as a means of reducing alcohol use among young people living with HIV.