Stress, Marginalization, and Disruption: A Qualitative Rapid Situational Assessment of Substance Users and HIV Risk in Lebanon.

Lebanon is a diverse and dynamic nation of six million people that has experienced considerable disruption for the last two decades. The Syrian Civil War, which began in 2011, resulted in the displacement of 1.1 million Syrians to Lebanon. Today, Lebanon is the country with the largest per capita number of refugees in the world. In addition, the country experienced a social, economic, and political crisis in 2019 that destabilized the entire society-circumstances that were further complicated by COVID-19 pandemic. With all of the competing calamities in Lebanon, there has been limited scientific investigation into substance use and the risk of HIV infection among the country's population. To address this gap in knowledge, a qualitative rapid situational assessment (RSA) of substance use and risk of HIV infection in and around Beirut, the nation's capital, was conducted. The goal of this analysis is to describe the demographics and drug use patterns of this population, explore their HIV knowledge and risks, and build knowledge about their perceptions of and access to substance use treatment and other social services.

Exploring the bidirectional relationship between chronic disease and depression among female Syrian refugees and Jordanians: a qualitative analysis.

BACKGROUND: Nearly 700 000 Syrian refugees currently reside in Jordan. Chronic disease and neuropsychiatric conditions are leading contributors of morbidity among refugee and host communities. The bidirectional relationship between depression and chronic disease is not well studied among displaced Syrian or Jordanian women. AIMS: This qualitative study explores the bidirectional relationship between chronic illness and comorbid depression, as well as related themes, among Jordanian and Syrian women with known chronic disease-populations that receive medical care through distinct and evolving health care structures-to assist providers and policy makers in creating culturally sensitive interventions. METHODS: Forty Jordanian women and Syrian refugees with chronic disease were interviewed at four clinical settings in Amman, Jordan. Data collection occurred from June-August 2017. Content analysis was completed with Dedoose, a qualitative coding software. RESULTS: The majority of Syrian women endorsed a relationship between their chronic disease and depression. Some women felt too depressed to take medication for chronic conditions, while others felt depression contributed to chronic illnesses. Syrian women reported less perceived social support than Jordanian women. Although some Syrians were unable to afford medications, they reported fewer negative health care experiences than Jordanians. Both populations endorsed female-specific hardships impacting their mental health, including the demands of motherhood, household duties, and marital strife. CONCLUSION: This study explores the intersection of depression and chronic disease among Syrian and Jordanian women. By documenting stressors and experiences accessing health care, mental health and chronic disease interventions can be integrated and tailored to these populations.

Energy drinks consumption and perceptions among University Students in Beirut, Lebanon: A mixed methods approach.

BACKGROUND: Energy drinks (ED) are caffeine- and sugar-rich beverages with other ingredients that are marketed for their energy-boosting and performance-enhancing effects. The consumption of these drinks, with and without alcohol, is dramatically increasing worldwide, despite the reported side effects and potential harms to consumers. Few studies, to date, have explored the perceptions and experiences of young adults towards these beverages. OBJECTIVE: The present study aimed to explore the consumption patterns and correlates of ED consumption, as well as the perceptions and experiences of university students in Lebanon towards these beverages. METHODS: A sequential explanatory mixed-methods approach was adopted. Data collection was conducted in two private universities in Beirut, Lebanon. A self-administered 36-item quantitative survey was first used to explore the prevalence and correlates of ED consumption among a convenience sample of university students (n = 226). The survey included questions related to socio-demographic characteristics, anthropometric measurements, and other lifestyle behaviors, including physical activity of university students. The subsequent qualitative phase consisted of focus group discussions (FGD) conducted to further examine the perceptions and experiences of university students towards ED. Descriptive statistics and logistic regression analyses were conducted using survey data, whereas the transcribed FGD were analyzed thematically. RESULTS: A total of 226 university students completed the survey. Results showed that 45% of survey respondents consumed ED at least once in their life (ever consumers), among which 30% reported consumption of ED mixed with alcohol (AmED). Adjusting for socio-demographic and anthropometric characteristics, coffee and sports drinks consumption were significantly associated with ED (OR = 2.45, 95% CI = 1.20, 5.00, and OR = 4.88, 95%CI = 2.41, 9.88, respectively). In addition, physically active participants were 1.89 times (95%CI = 1.01, 3.51) more likely to consume ED compared to their inactive counterparts. During the qualitative phase, a total of six FGD were conducted with 29 university students, who reported consuming ED at least once per month. Three main themes were derived reflecting individual-, interpersonal/social- and environmental-level factors affecting ED consumption among university students. These themes were further supported by eight subthemes, including: perceived benefits of ED, experienced side effects, misinformation about content of ED, peer pressure and social image, as well as affordability and accessibility of ED. CONCLUSION: Findings highlight the need for public health policies and programs to curb the growing public health phenomenon of ED consumption amongst university students. Such programs should consider the multi-level factors affecting ED consumption at the individual, interpersonal/social, and environmental levels, including educational campaigns on ED potential harms, regulating ED content and labeling, as well as restricting sales and marketing of these beverages, especially among young consumers.