Restricted accessResearch articleFirst published online 2026
Latent health behavior classes and associations with depressive symptoms and metabolic syndrome among women with and without HIV in the MACS/WIHS Combined Cohort Study
We used 2020–2022 data from the MACS/WIHS Combined Cohort Study (MWCCS) of 1689 women with and without HIV to identify latent health behavior classes (HBCs) underlying covariation in diet, physical inactivity, and substance use. We tested if HBCs predicted key mental and physical health outcomes, including depression and metabolic syndrome (MetS), at a 1-year follow-up. A latent class analysis yielded three HBCs: (1) Class 1: Healthiest, (2) Class 2: Poor Diet with Substance Use, and (3) Class 3: Physical Inactivity and Poor Diet with Low Substance Use. Women with older age, higher income, and HIV had greater odds of being in Class 1. Class 2 had the highest odds of elevated depressive symptoms when controlling for age, income, menopause stage, and HIV status. Although Class 3 had the highest odds of MetS, the association between HBC and MetS was nonsignificant. Findings suggest complex health behavior patterns predict depressive symptoms.
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