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In our work at El Centro, we have found many instances of co-occurring conditions among the individuals and families we serve. For example:

- In a precursor to our SET-Recovery study, we found that 59% of HIV+ (predominantly African American) women who were recovering from substance abuse also had symptoms of PTSD. 

- We found that most of the Hispanic adolescents entering our CIFTA-Prevention study had three or more co-occurring health or mental health conditions. For example:

61% were depressed,
71% had ADHD, and
57% met the criteria for conduct disorder. 

- These co-occurring problems in turn place the teens at greater risk for substance abuse and risky sexual behavior.

Our experience in finding many intertwined health and mental health conditions in the individuals and families we serve led us to develop a conceptual model to help answer these questions:

- How are mental health, substance abuse, violence, and risk for HIV and other STIs related among minority group members, and how do these conditions interact?

- What are the individual, relationship, cultural and socio-economic factors that may serve as common risk and protective factors for these conditions?

We have found that, among Hispanics, socioeconomic disadvantage, acculturation and stress help predict the co-occurrence of these health and mental health conditions, and that strong family ties help protect against their effects. 

Being able to fully and clearly understand how health and mental health conditions co-occur and interact, as well as the risk and protective factors for these conditions, is essential to our development of effective, culturally-tailored interventions.