Examining a Syndemics Network Among Young Latino Men Who Have Sex with Men

Abstract

Background-Although studies consistently find that syndemic indicators are additively associated with increased HIV/STI risk behavior (e.g., condomless anal sex; CAS) among men who have sex with men (MSM), information is lacking about how syndemic indicators are associated with each other. Young Latino MSM are one of the most at-risk groups for acquiring HIV in the U.S. Understanding the associations of syndemic indicators with each other and with CAS may improve understanding of how to enhance sexual and behavioral health in this population.Method-Network analysis using the graphical LASSO (glasso) algorithm was employed to explore associations between CAS and syndemic indicators among 139 young Latino MSM. Structural and psychosocial syndemic indicators were assessed via self-report. CAS was defined as the number of partners in the past 3 months with whom one engaged in CAS. Results-Resultsof the network analysis suggested the variables with the highest centrality were unstable housing, prison history, childhood sexual abuse, and CAS. Specific significant associations included links between CAS and alcohol use (b = 0.40), childhood sexual abuse and unstable housing (b = − 0.75), alcohol use and childhood sexual abuse (b = 0.40), and substance use and intimate partner violence (b = 0.43).

Psychosocial and Culturally-Specific Factors Related to Intimate Partner Violence Victimization among a Sample of Latino Sexual Minority Cis Men in the U.S.

“…But there is a smaller established body of research examining the associations between syndemic indicators and IPV victimization within the sample population. Further, the application of the syndemic framework on Latino SMM has highlighted that depression, CSA, drug use, and problematic drinking represent significant influences on HIV risk within this population (Blashill et al, 2020; Lee et al, 2020; Martinez et al, 2016). More recent research on syndemic factors and health among Latino SMM has incorporated culturally relevant variables (i.e., acculturative stress and immigration) as risk factors of adverse health among this population (González-Guarda et al, 2016; Lee et al, 2020; Martinez et al, 2020).…”

“…The association between substance use and IPV in SMM (Buller et al, 2014; Duncan et al, 2018) has been well-established in the larger body of research. Fewer studies have replicated the association in Latino SMM (De Santis et al, 2012, 2014; Lee et al, 2020). Latino SMM report greater rates of substance use and substance-use disorders compared to heterosexual Latino men (Cochran et al, 2007) and non-Latino SMM (Irwin & Morgenstern, 2005; Slater et al, 2017).…”

“…However, the examination of the relationship between CSA and IPV victimization in Latino SMM is comparatively understudied. The small body of work has produced mixed findings with some studies indicating CSA is associated with increased the risk of IPV (Toro-Alfonso & Rodríguez-Madera, 2004a, 2004b; Welles et al, 2011), while other studies found that CSA was not associated with IPV among Latino SMM (Feldman et al, 2007; Lee et al, 2020). Given that Latino SMM are more likely to experience CSA (Arreola et al, 2005; Parsons et al, 2017; Phillips et al, 2014) and IPV (Feldman et al, 2007; Nieves-Rosa et al, 2000; Stephenson et al, 2013) compared to non-Hispanic White SMM, additional research is required to understand the relationship between these two factors.…”

Structural Syndemics and Antiretroviral Medication Adherence Among Black Sexual Minority Men Living With HIV

“…Structural indicators, counted alongside psychosocial factors, were found to be associated with poor ART adherence, detectable viral load, 33,35 and being interrelated, demonstrating a syndemic relationship. 36,37 A study of people living with HIV who inject drugs found lower odds of adherence to HIV medication when participants reported 3 or more psychosocial problems and lower likelihood of being virally suppressed when reporting 4 or more psychosocial problems. 34 For this study, psychosocial problems encompassed both structural (ie, housing instability and incarceration history) and behavioral (ie, experiences of abuse and psychological distress) factors, which were used to develop a count score by adding the number of experienced psychosocial problems and later examined in association with HIV treatment adherence outcomes.…”