Psychosocial Health Problems Increase Risk for HIV Among Urban Young Men Who Have Sex With Men: Preliminary Evidence of a Syndemic in Need of Attention

Institute for Juvenile Research at the University of Illinois at Chicago, Department of Psychiatry, and Children's Memorial Hospital, IL 60608, USA.
Annals of Behavioral Medicine (Impact Factor: 4.2). 09/2007; 34(1):37-45. DOI: 10.1080/08836610701495268
Source: PubMed


Young men who have sex with men (YMSM) experience disparities in HIV rates and potentially in mental health, substance abuse, and exposure to violence.
We assessed the extent to which these psychosocial health problems had an additive effect on increasing HIV risk among YMSM.
An urban sample of 310 ethnically diverse YMSM reported on psychosocial health problems, sexual risk behaviors, and HIV status. A count of psychosocial health problems was calculated to test the additive relationship to HIV risk.
The prevalence of psychosocial health problems varied from 23% for regular binge drinking to 34% for experiencing partner violence. Rates of sexual risk behaviors were high and 14% of YMSM reported receiving a HIV+ test result. Psychosocial health problems cooccurred, as evidenced by significant bivariate odds ratios (ORs) between 12 of the 15 associations tested. Number of psychosocial health problems significantly increased the odds of having multiple anal sex partners (OR=1.24), unprotected anal sex (OR=1.42), and an HIV-positive status (OR 1.42), after controlling for demographic factors.
These data suggest the existence of cooccurring epidemics, or "syndemic," of health problems among YMSM. Disparities exist not only in the prevalence of HIV among YMSM but also in research to combat the epidemic within this vulnerable population. Future research is needed to identify risk and resiliency factors across the range of health disparities and develop interventions that address this syndemic.

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    • "They found that the presence of the co-occurring epidemics increased the likelihood that MSM had engaged in unprotected sex and increased their likelihood of being HIV-positive. A number of authors, particularly during the past few years, have written about syndemics and Syndemics Theory as they apply to sexual risk taking and the HIV epidemic (Gielen et al., 2007; Mustanski , Garofalo, Herrick, & Donenberg, 2007; Romero-Daza, Weeks, & Singer, 2003; Senn, Carey, & Vanable, 2010; Singer et al., 2006), including specific mention of the applicability of the concept and theory to men who have sex with men (Klein, 2011b; Mustanski et al., 2007). "
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    Journal of Gay & Lesbian Mental Health 04/2014; 18(2):164-189. DOI:10.1080/19359705.2013.834858
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    • "The differences between the terms comorbid and syndemic, as Mustanski et al. stress [23], is not simply semantic. Research guided by a comorbidity model tends to focus on the disease boundaries, overlaps, and prioritization, while syndemic research directs attention to “communities experiencing co-occurring epidemics that additively increase negative health consequences [23]”. The adverse synergistic interaction of diseases in syndemics, in other words, multiplies the burden of disease in a population, and, under given conditions, can escalate contagion, disease progression, disability, and mortality. "
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    • "This manuscript presents findings from one of the first research studies to test a theory of syndemics in aging HIV-positive gay, bisexual, and other MSM. Although previous studies have highlighted the strong relations between psychosocial burdens and sexual risk-taking in age-diverse samples of MSM (Egan et al. 2011; Moeller et al. 2011; Stall et al. 2003), much of the focus of this research has been on the applicability of syndemics theory to understanding sexual risk-taking in adolescent, emerging, and young adult gay, bisexual, and other MSM (Halkitis et al. 2013; Mustanski et al. 2007; Solomon et al. 2011; Storhlom et al. 2011). Like these previous investigations, we demonstrate a high level of association between psychosocial burdens and UAI, with the men who possessed higher overall burden scores also indicating a higher likelihood of engaging in UAI. "
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