Optimism and Education Buffer the Effects of Syndemic Conditions on HIV Status Among African American Men Who Have Sex with Men

Abstract

The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two--optimism and education--buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors.

HIV Vulnerability and Coexisting Psychosocial Health Problems amongTanzanian Men who have Sex with Men from the Perspective of an African Syndemic Model

“…This substantiates the central tenet of syndemic theory, which says that participants who were exposed to a greater number of psychosocial health problems also engaged in more risk-related sexual behavior [25]. These findings are congruous with those of previous studies conducted among an American sample of MSM and among MSM in China and Thailand [23,[25][26][27][28]49].…”

“…Singer et al stated that "in syndemics, the interaction of diseases or other health problems commonly arises because of adverse social conditions that put socially devalued groups at heightened risk" [22]. Considerable compelling evidence has revealed the syndemic induction of both HIV infection and HIV risk-related sexual behavior in an American sample of MSM, but no study has been conducted to date among MSM in SSA to explore similar trends [23][24][25][26].…”

Thriving and Adapting: Resilience, Sense of Community, and Syndemics among Young Black Gay and Bisexual Men

“…In their probability sample of nearly 3000 GBM, the odds a participant engaged in unprotected anal intercourse increased based on the number of psychosocial problems he experienced; the odds of a participant being HIV infected also increased with the addition of each psychosocial problem (Stall et al, 2003). Since Stall et al (2003) tested the additive effect of psychosocial problems on the sexual health of GBM, researchers have located similar syndemics among young GBM (Mustanski, Garofalo, Herrick & Donenberg, 2007) and Black GBM (Dyer et al, 2012;O'Leary, Jemmott, Stevens, Rutledge & Icard, 2014).…”

“…Race, gender identity, class, and/or sexual identity may intersect among Black sexual minority men in ways that influence vulnerability to syndemics. Studies of syndemics among Black GBM have not yet accounted for other facets of identity such as race (Dyer et al, 2012;O'Leary et al, 2014). Studies inclusive of racial minorities should consider racism and racial identity formation as antecedents of syndemics.…”

Resilience Factors as a Buffer against the Effects of Syndemic Conditions on HIV Risk and Infection among Tanzanian MSM

“…Nevertheless, empiric applications of syndemic theory among MSM in the United States and and among marginalized women in South Africa have highlighted the coexisting and synergistic influence of multiple psychosocial health problems as drivers of HIV epidemics among these socially marginalized subpopulations [30,39,54]. The results of these studies offer a way of advancing HIV-prevention effectiveness among MSM in high-risk contexts, and some have been extended by resilience theory to identify protective factors that may mitigate the syndemic production of HIV among these sexual minorities [2,37].…”