Health, Sexual Health, and Syndemics: Toward a Better Approach to STI and HIV Preventive Interventions for Men Who Have Sex with Men (MSM) in the United States

Psychosocial Health Conditions and HIV Prevalence and Incidence in a Cohort of Men Who have Sex with Men in Bangkok, Thailand: Evidence of a Syndemic Effect

“…Stall and colleagues [21, 26] expanded on this hypothesis, proposing a model for a developmental pathway of syndemics among American MSM. In addition, they proposed several methods that may improve gay men’s health, including strengthening social networks, integrating and tailoring public health services, and initiating improved research into the health issues of racial and ethnic minorities [21, 26, 46]. These models, as well as our results, suggest that combinations of psychosocial health conditions may have supplemental effects on other health conditions, such as HIV infection, further down the causal pathway.…”

“…The syndemic concept proposes that multiple epidemics form a condition that affects the population in a way that is distinct from individual epidemics [24]. Conditions arising in early adolescence may also play a role in HIV vulnerability [21, 25, 26]. A set of recent meta-analyses have shown that several psychosocial health conditions, including substance abuse [27], violence victimization [28], and having sex under the influence of drugs or alcohol [29], arise in adolescence or early adulthood among MSM primarily in North America.…”

Using Syndemic Theory to Understand Vulnerability to HIV Infection among Black and Latino Men in New York City

“…[21][22][23][24] For example, one study found that in a sample of almost 3,000 MSM (21 % ethnic/racial minorities), polydrug use, depression, childhood sexual abuse, and intimate partner violence were each related to one another and independently associated with HIV seropositivity and highrisk sexual behavior. 21 Moreover, these psychosocial risks were observed to have an additive effect on HIV risks: with increasing numbers of risks, there were increases in the prevalence of high-risk sex and HIV infection.…”

“…Subsequent work by Stall and colleagues identified other psychosocial risks contributing to syndemic conditions, including sexual compulsiveness, stress, and discrimination. 23,24 Perry Halkitis and his colleagues 25 also have employed syndemic theory to understand vulnerability to poor health outcomes among young MSM. Data were collected from 598 young (between the ages of 18 and 19 years) MSM living in NYC, the majority of whom (53 %) were Hispanic or Black.…”

Enhancing the Responsible Conduct of Sexual Health Prevention Research Across Global and Local Contexts: Training for Evidence-Based Research Ethics

“…Gay, bisexual, and transgender youth living in Thailand exhibit higher prevalence of mental heath disorders, childhood sexual abuse, drug and alcohol abuse, intimate partner violence, peer victimization and bullying, and sexually transmitted infections, including HIV (CDC, 2013). Reasons for this have been postulated to include deep-rooted societal and internalized homophobia, gender and sexual orientation-based discrimination and stigma, and minority stress (Guadamuz et al, 2013). As in the United States (Fisher, 2002, 2003a; Fisher et al, 2013; Fisher & Mustanski, 2014) and South Africa (Thokoane, this issue), laws and cultural mores create reluctance on the part of ethics review committees to waive the requirement for guardian permission for adolescent participation in sexual health research.…”