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

Wilson, Patrick A.; Nanín, José; Amesty, Silvia; Wallace, Scyatta A.; Cherenack, Emily M.; Fullilove, Robert E.

doi:10.1007/s11524-014-9895-2

Cited by 104 publications

(80 citation statements)

References 78 publications

(90 reference statements)

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“…Consistent with existing research, we hypothesize that the resilience factors selfefficacy, hardiness/coping, and social support, individually and collectively, have a compensatory effect on poor psychosocial outcomes. We also view YBGBM to be at a disadvantage for experiencing poor psychosocial outcomes based on the syndemic conditions and minority stress that these men face (Mustanski et al, 2007;Penniman Dyer et al, 2012;Wilson et al, 2014).…”

Section: Goals Of the Current Studymentioning

confidence: 95%

“…These problems constitute a syndemic that exacerbates poor health among YBGBM (Mustanski, Garofalo, Herrick & Donenberg, 2007;Penniman Dyer et al, 2012;Wilson et al, 2014) and other vulnerable populations (Batchelder, Gonzalez, Palma, Schoenbaum & Lounsbury, 2015;Halkitis et al, 2012;Mimiaga et al, 2015;Nehl, Klein, Sterk & Elifson, 2015;Stall, Friedman & Catania, 2007). Through both structural and interpersonal mechanisms, minority stress shapes outcomes among YBGBM by exposing them to race-and sexual orientation-based stigma and lower levels of personal and social resources that can be used to combat stress (Hatzenbuehler, 2010;Meyer, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

Wilson

Meyer

Antebi-Gruszka

et al. 2016

American J of Comm Psychol

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Young Black gay/bisexual men (YBGBM) are affected by contextual stressors-namely syndemic conditions and minority stress-that threaten their health and well-being. Resilience is a process through which YBGBM achieve positive psychosocial outcomes in the face of adverse conditions. Self-efficacy, hardiness and adaptive coping, and social support may be important resilience factors for YBGBM. This study explores different profiles of these resilience factors in 228 YBGBM in New York City and compares profiles on psychological distress, mental health, and other psychosocial factors. Four profiles of resilience were identified: (a) Low self-efficacy and hardiness/adaptive coping (23.5%); (b) Low peer and parental support (21.2%); (c) High peer support, low father support (34.5%); and (d) High father and mother support, selfefficacy, and hardiness/adaptive coping (20.8%). YBGBM in profile 1 scored markedly higher on distress (d = .74) and lower on mental health functioning (d = .93) compared to men in the other profiles. Results suggest that self-efficacy and hardiness/adaptive coping may play a more important role in protecting YBGBM from risks compared to social support and should be targeted in interventions. The findings show that resilience is a multidimensional construct and support the notion that there are different patterns of resilience among YBGBM.

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Section: Goals Of the Current Studymentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

Wilson

Meyer

Antebi-Gruszka

et al. 2016

American J of Comm Psychol

Self Cite

View full text Add to dashboard Cite

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“…Reducing HIV disparities among Black GBM has proved especially difficult due to the interaction of multiple epidemics-substance abuse, trauma, poor mental health, and HIV-within Black communities (Wilson et al, 2014). Syndemics provides a way of conceptualizing the multiple, interacting epidemics that are antecedents of HIV among marginalized populations.…”

Section: The Syndemics Of Hiv Infectionmentioning

confidence: 99%

“…Indeed, a long-lingering paradox of the high rates of infection among Black GBM remains: they consistently report less risk behavior than their non-Black counterparts (Feldman, 2010;Millett, Flores, Peterson & Bakeman, 2007).The largely unwritten story is that even though Black GBM contend with a multitude of social stressors, a sizable number of GBM must have reservoirs of resilience to mitigate and withstand negative sexual and psychosocial health outcomes. Despite the call for a resilience-based approach to the study of syndemics (Herrick et al, 2011;Wilson et al, 2014), the empirical syndemics literature continues to focus on the identification of risk factors that make men vulnerable to syndemics (Dyer et al, 2012;Egan et al, 2011;Herrick et al, 2012Herrick et al, , 2014. Inquiry examining sources of GBM's resilience remains limited.…”

Section: Syndemics and Resiliencementioning

confidence: 99%

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

Reed

Miller

2016

American J of Comm Psychol

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We examined resilience associated with the avoidance of psychosocial health conditions (i.e., syndemics) that increase vulnerability for HIV among young Black gay and bisexual men. We used analytic induction to compare a sample of 23 men who showed no evidence of syndemic conditions to a sample of 23 men who experienced syndemic conditions. The men who avoided syndemics reported supportive relationships with people who helped them to develop a strong sense of identity, provided them with opportunities to give back to their communities, and promoted positive norms about health. In contrast, the men experiencing syndemic conditions described numerous instances of trauma and oppression that infringed upon their desire to form positive relationships. Among these men, experiences of oppression were associated with shame, identity incongruence, social isolation, relational disconnection, mistrust of men, and expectations of further marginalization. We examined participants' experiences through the framework of the psychosocial sense of community. Results of this study provide evidence for using strength-based intervention strategies to prevent syndemic conditions. Findings suggest that to attenuate socio-structural barriers to health and comorbid psychosocial health concerns, interventions must address young men's social isolation and promote positive identity and sense of community. Keywords SyndemicsHIV prevention Gay and bisexual men Black men Resilience Adolescents and young adults

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“…A syndemic framework may be useful in understanding the management of diabetes in this population because these co-occurring conditions may synergistically affect glycemic control [20][21][22][23]. For MSM with HIV, management of comorbid chronic conditions such as diabetes may prove particularly challenging due to increased HIV-associated risks of lipodystrophy, coronary artery disease, and chronic kidney disease, which make glycemic control harder to achieve [24].…”

Section: Introductionmentioning

confidence: 99%

The Utility of a Syndemic Framework in Understanding Chronic Disease Management Among HIV-Infected and Type 2 Diabetic Men Who Have Sex with Men

et al. 2016

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Syndemic theory posits that epidemics of multiple physical and psychosocial problems co-occur among disadvantaged groups due to adverse social conditions. Although sexual minority populations are often stigmatized and vulnerable to multiple health problems, the syndemic perspective has been underutilized in understanding chronic disease. To assess the potential utility of this perspective in understanding the management of co-occurring HIV and Type 2 diabetes, we used linear regression to examine glycemic control (A1c) among men who have sex with men (MSM) with both HIV and Type 2 diabetes (n = 88). Bivariable linear regression explored potential syndemic correlates of inadequate glycemic control. Compared to those with adequate glycemic control (A1c ≤ 7.5 %), more men with inadequate glycemic control (A1c > 7.5 %) had hypertension (70 vs. 46 %, p = 0.034), high triglycerides (93 vs. 61 %, p = 0.002), depression (67 vs. 39 %, p = 0.018), current substance abuse (15 vs. 2 %, p = 0.014), and detectable levels of HIV (i.e., viral load ≥75 copies per ml blood; 30 vs. 10 %, p = 0.019). In multivariable regression controlling for age, the factors that were independently associated with higher A1c were high triglycerides, substance use, and detectable HIV viral load, suggesting that chronic disease management among MSM is complex and challenging for patients and providers. Findings also suggest that syndemic theory can be a clarifying lens for understanding chronic disease management among sexual minority stigmatized populations. Interventions targeting single conditions may be inadequate when multiple conditions co-occur; thus, research using a syndemic framework may be helpful in identifying intervention strategies that target multiple co-occurring conditions.

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

Cited by 104 publications

References 78 publications

Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

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

The Utility of a Syndemic Framework in Understanding Chronic Disease Management Among HIV-Infected and Type 2 Diabetic Men Who Have Sex with Men

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