Longitudinal Effects of Syndemics on HIV-Positive Sexual Minority Men's Sexual Health Behaviors.
Audrey HarknessSierra A BainterConall O'CleirighChristopher AlbrightKenneth H MayerSteven A SafrenPublished in: Archives of sexual behavior (2019)
This study examined the longitudinal effects of co-occurring psychosocial concerns, or syndemics, on HIV-positive sexual minority men's likelihood of engaging in serodiscordant condomless anal sex (CAS), a health behavior with implications for personal and public health. Participants included 390 HIV-positive sexual minority men from two prior secondary prevention trials. Over the course of the 1-year data collection period (up to 5 observations per participant), participants completed self-report measures of CAS, as well as six syndemic factors: post-traumatic stress disorder, childhood sexual abuse, depression, anxiety, alcohol abuse, and polysubstance/stimulant use. We employed multilevel modeling to examine the longitudinal additive effect of syndemics on serodiscordant CAS (binary) over the 1-year period. The number of syndemic conditions was a significant predictor of CAS, with each additional syndemic associated with 1.41 greater odds of CAS (p = .0004; 95% CI [1.16, 1.70]). Both the between-person (p = .0121, 95% CI [1.07, 1.69]) and within-person (p = .01, 95% CI [1.11, 2.10]) effects of syndemics were significant predictors, showing that an increase in the number of syndemic conditions across person and time both increased odds of CAS. Interventions addressing HIV-positive sexual minority men's sexual health behaviors should address the potential impact of co-occurring psychosocial concerns that affect these behaviors. This will benefit this population's personal sexual health and reduce transmission of HIV and STIs among sexual minority men.
Keyphrases
- hiv positive
- men who have sex with men
- crispr cas
- genome editing
- antiretroviral therapy
- mental health
- south africa
- hiv testing
- public health
- middle aged
- human immunodeficiency virus
- hiv infected
- healthcare
- hiv aids
- cross sectional
- physical activity
- sleep quality
- depressive symptoms
- social media
- autism spectrum disorder
- big data
- high grade
- social support
- electronic health record