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

Abstract

Background: In the extremely homophobic conditions in Tanzania and other countries in sub-Saharan Africa (SSA), men who have sex with men (MSM) experience disproportionate amounts of both HIV infection and psychosocial health problems, but no research has been conducted to examine the synergistic or additive effects of these adversities on their experiences. While the predominantly deficit-based research approach has identified various HIV risks and vulnerabilities, any naturally occurring protective and resilience factors that these men naturally employ to these health-related adversities remain undetermined.

Informing theoretical development of salutogenic, asset-based health improvement to reduce syndemics among gay, bisexual and other men who have sex with men: Empirical evidence from secondary analysis of multi-national, online cross-sectional surveys

“…The protective effect of sense of coherence and aspirations demonstrates a theoretical mechanism by which salutogenic, asset-based approaches to health improvement could function. Previous research has examined the protective effect of resilience on individual outcomes, such as HIV (Adeboye et al, 2017; Chakrapani et al, 2017, 2019; Cleland et al, 2017; Hart et al, 2017; McNair et al, 2018; Woodward, Banks, Marks, & Pantalone, 2017), and our study provides empirical evidence that capitalising on and promoting such community assets could indeed be a means of countering syndemics. It points to the need for an integrated approach; capitalising on collective assets at the organisational-, community- and individual-level.…”

“…While evidence of effectiveness of asset-based approaches is still limited (Morgan & Ziglio, 2007), and largely absent from health improvement efforts with GBMSM so far, there have been calls to develop such efforts to reduce their multiple, interrelated health inequalities (Halkitis, 2013; Halkitis, Krause, & Vieira, 2017; Herrick et al, 2011, 2014; Mayer et al, 2012). Asset or strengths and resilience approaches have been suggested as a means of countering syndemics (Chakrapani, Kaur, Newman, Mittal, & Kumar, 2019; Herrick et al, 2011; Stall, Friedman, & Catania, 2008), but the approach has not been fully defined, or tested, with studies again focussing on the unitary outcomes of HIV, sexual risk behaviour or substance use (Adeboye et al, 2017; Chakrapani, Newman, Shunmugam, Logie, & Samuel, 2017; Chakrapani et al, 2019; Cleland, Lanza, Vasilenko, & Gwadz, 2017; Halkitis et al, 2017; Hart et al, 2017; McNair et al, 2018).…”

Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review

“…Other researchers coined the “SAVA” term to characterize a triplex health condition that involves the interaction between Substance Abuse, Violence, and AIDS [ 13 , 14 ]. In the present, these lexicalized acronyms have become widely published, and new frameworks have appeared, such as the “SUMIC” syndemic (i.e., Substance Use, Mental Illness, and Familial Conflict non-negotiation) [ 15 ], “SAVID” (i.e., Substance abuse during condomless sex, childhood and adolescent sexual abuse, violence, internalized homonegativity, and depression) [ 16 ], and “PHAMILIS” (i.e., Physical Health problems, Abuse, Mental Illness, Loss, Instability, and Substance use) [ 17 , 18 ].…”