Characterizing the role of intersecting stigmas and sustained inequities in driving HIV syndemics across low-to-middle-income settings

Abstract

Purpose of review In 2020, key populations around the world still have disproportionate risks for HIV acquisition and experiencing HIV-related syndemics. This review presents current data around HIV-related syndemics among key populations globally, and on the role of intersecting stigmas in producing these syndemics in low-to-middle-income settings. Recent findings Sex workers, sexual and gender minorities, prisoners, and people who use drugs experience high burdens of tuberculosis, sexually transmitted infections, viral hepatitis, and violence linked to heightened HIV-related risks or acquisition. Adverse sexual, reproductive, and mental health outcomes are also common and similarly amplify HIV acquisition and transmission risks, highlighting the need for psychosocial and reproductive health services for key populations. Summary Achieving the promise of biomedical interventions to support HIV care and prevention requires action towards addressing syndemics of HIV, and the stigmas that reproduce them, among those most marginalized globally.

The COVID-19 Pandemic Seen from a Syndemic Perspective: The LGBTQIA2SP+ Community

“…The syndemics theory has enabled scholars to identify particular sub-populations and specific community strata at higher risks for developing/spreading HIV/AIDS, such as gay and bisexual individuals and other men having sex with men (GBMSM), or youth living with HIV (YLWH). Other examples of vulnerable and frail populations include individuals suffering from mental health disorders and other issues (such as depression, binge drinking, (poly-)substance use, street drug use, psychological distress, childhood sexual abuse, intimate partner violence and sexual assault as well as other psychosocial risk factors) or subjects experiencing stigma, a lack of strong social support networks, other psychological burdens, and/or low socio-economic status [1][2][3][4][5][6][7][8].…”

Enrollment and retention of female sex workers in HIV care in health facilities in Mbarara city

“…HIV-related stigma could be based on the actual or perceived status of living with HIV. This can lead to fear or avoidance of health services ( 28 ).…”

Pharmaco‐virological algorithm to target risk of drug resistance among a population of HIV‐infected key populations in Togo

“…Overall, data from our findings and from studies in the African region indicates that there is an important gap in the achievement of the HIV treatment cascade targets among FSW and MSM. The first challenge is in key populations' linkage to care, with barriers such as stigma and discrimination facilitating low access and avoidance of health care services 13,14 . This raises the question of the relevance of a differentiated model of care specific to key populations, taking into account their unique needs.…”