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Kiffer G Card, Nathan J Lachowsky, Heather L Armstrong, Zishan Cui, Lu Wang, Paul Sereda, Jody Jollimore, Thomas L Patterson, Trevor Corneil, Robert S Hogg, Eric A Roth, David M Moore
INTRODUCTION: Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other. METHODS: We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged ≥16 years, recruited in Metro Vancouver using respondent driven sampling...
March 6, 2018: Addictive Behaviors
Carmen H Logie, Candice L Lys, Nicole Schott, Lisa Dias, Makenzie R Zouboules, Kayley Mackay
Scant research has addressed health and well-being among lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons in the Arctic. The Northwest Territories (NWT) has among Canada's highest rates of sexually transmitted infections (STIs). LGBTQ persons in NWT are at the nexus of LGBTQ and Arctic health disparities. Yet little is known of their sexual health needs. This qualitative study explored the sexual health needs of LGBTQ persons in the NWT. We conducted semi-structured, in-depth interviews with 51 participants, including 16 LGBTQ youth aged 15-24, 21 LGBTQ adults aged 25 and above, and 14 key informants who worked with LGBTQ persons...
March 13, 2018: Global Public Health
Patrick O'Byrne, Paul MacPherson, Lauren Orser
We trialed a nurse-led HIV postexposure prophylaxis (PEP) program in two sexually transmitted infection clinics in Ottawa, Canada. From September 5, 2013 to September 4, 2015, 112 persons sought PEP: 103 were male, of whom 84 were men who have sex with men (MSM). Seventy-two patients (59 MSM) initiated PEP; 11 were diagnosed with HIV: 6 diagnoses occurred during initial assessment (all MSM; 1 also shared injection equipment); 5 MSM were diagnosed with HIV within 1 year of seeking PEP. This level of positivity indicated that, when access is facilitated, individuals at high risk of HIV seek PEP...
February 17, 2018: Journal of the Association of Nurses in AIDS Care: JANAC
Marilou Gagnon
Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects...
March 12, 2018: AIDS Care
Idia B Thurston, Kathryn H Howell, Rebecca C Kamody, Courtney Maclin-Akinyemi, Jessica Mandell
Physical and emotional adversities in mothers have rippling effects across the family system. While an association between individual maternal adversities and problematic mental health outcomes has been established, less is known about co-existing adversities in mothers. Consistent with the syndemic conceptual framework, we examined the co-occurrence of Substance Abuse, Violence, and AIDS/HIV (i.e., SAVA), which are three adversities that uniquely affect racial/ethnic minorities, individuals living in poverty, and people in urban communities...
March 2, 2018: AIDS Care
James Wilton, Syed W Noor, Alexandre Schnubb, James Lawless, Trevor A Hart, Troy Grennan, Shawn Fowler, John Maxwell, Darrell H S Tan
BACKGROUND: To maximize public health impact and cost-effectiveness, HIV pre-exposure prophylaxis (PrEP) must reach individuals at high HIV risk. Referrals for PrEP can be self- or provider-initiated, but there are several challenges to both. We assessed whether HIV risk differed by referral source among gay, bisexual and other men who have sex (gbMSM) screening for an HIV PrEP demonstration project. METHODS: PREPARATORY-5 was an open-label PrEP demonstration project enrolling gbMSM at high risk of HIV acquisition in Toronto, Canada...
February 27, 2018: BMC Public Health
Katherine G Quinn, Sarah J Reed, Julia Dickson-Gomez, Jeffrey A Kelly
Syndemic theory seeks to understand the interactions and clustering of disease and social conditions and explain racial disparities in HIV. Traditionally applied to HIV risk, this study characterizes the syndemic challenges of engagement in care among Black men living with HIV and provides insight into potential HIV treatment interventions to retain vulnerable individuals in care. Interviews were conducted with 23 HIV-positive men who were either out-of-care or nonadherent to antiretroviral therapy (ART). Interviews were audio recorded, transcribed verbatim, and coded using MAXQDA qualitative software...
February 1, 2018: Qualitative Health Research
Wei Wang, Chenchang Xiao, Xing Yao, Yinmei Yang, Hong Yan, Shiyue Li
BACKGROUND: Suicide is a serious cause of mortality worldwide and is considered as a psychiatric emergency. People living with HIV/AIDS (PLWHA) have higher rates of suicidal behavior than the general population. This study assessed the prevalence and verified the syndemic effect of psychosocial health conditions on suicidal ideation among PLWHA in China. METHODS: An institutional-based cross-sectional study was conducted from July to August 2016 in Nanjing, China, using a self-report questionnaire...
2018: PloS One
David C Perlman, Ashly E Jordan
PURPOSE OF REVIEW: This article reviews the case for recognizing (1) the epidemics of opioid misuse, overdose, hepatitis C virus, and HIV as a syndemic and (2) the importance of examining and addressing structural factors in responses to this syndemic. We focus on the current syndemic in the US, but also consider data from other locations to highlight the issues existing and arising in various contexts. RECENT FINDINGS: Advances in multi-level theory and statistical methods allow sound ecologic and multi-level analyses of the impact of structural factors on the syndemic...
February 19, 2018: Current HIV/AIDS Reports
Raquel B De Boni, Iona K Machado, Mauricio T L De Vasconcellos, Brenda Hoagland, Esper G Kallas, José Valdez Madruga, Nilo M Fernandes, Natalia B Cerqueira, Ronaldo I Moreira, Silvia P Goulart, Valdilea G Veloso, Beatriz Grinsztejn, Paula M Luz
BACKGROUND: Concurrent psychosocial problems may synergistically increase the risk of HIV infection (syndemics), representing a challenge for prevention. We aimed to evaluate the prevalence and associated factors of syndemics among men who have sex with men (MSM) and transgender women (TGW) enrolled in the Brazilian pre-exposure prophylaxis demonstration study (PrEP Brasil Study). METHODS: Secondary cross-sectional analysis of the PrEP Brasil Study was performed...
February 10, 2018: Drug and Alcohol Dependence
Andrea L Wirtz, Tonia C Poteat, Mannat Malik, Nancy Glass
Gender-based violence (GBV) is an umbrella term for any harm that is perpetrated against a person's will and that results from power inequalities based on gender roles. Most global estimates of GBV implicitly refer only to the experiences of cisgender, heterosexually identified women, which often comes at the exclusion of transgender and gender nonconforming (trans) populations. Those who perpetrate violence against trans populations often target gender nonconformity, gender expression or identity, and perceived sexual orientation and thus these forms of violence should be considered within broader discussions of GBV...
January 1, 2018: Trauma, Violence & Abuse
Olivier Ferlatte, Travis Salway, Hasina Samji, Naomi Dove, Dionne Gesink, Mark Gilbert, John L Oliffe, Troy Grennan, Jason Wong
BACKGROUND: We applied syndemic theory to explore the degree to which syndemic conditions explain the syphilis epidemic affecting Canadian gay and bisexual men who have sex with men (GBMSM). METHODS: Data from a national survey comprising 7872 GBMSM were analyzed using multivariable logistic regression to measure associations between recent syphilis diagnosis (RSD; in previous 12 months) and the following variables: (1) sociodemographic information (sexuality, HIV status, age, income, ethnicity, relationship status), (2) antigay stigma (bullying, physical violence, sexual violence, career discrimination, health care discrimination), (3) syndemic conditions (suicidality, intimate partner violence, depression, illicit substance use, binge drinking), (4) sexual behaviors, (5) health care discrimination, and (6) the cumulative count of antigay experiences and syndemic conditions...
March 2018: Sexually Transmitted Diseases
Louisa Gilbert, Timothy Hunt, Sholpan Primbetova, Assel Terlikbayeva, Mingway Chang, Elwin Wu, Tara McCrimmon, Nabila El-Bassel
OBJECTIVES: To evaluate the efficacy of a couple-based integrated HIV/HCV and overdose prevention intervention on non-fatal and fatal overdose and overdose prevention behaviors among people who use heroin or other opioids in Almaty, Kazakhstan. METHODS: We selected 479 participants who reported lifetime heroin or opioid use from a sample of 600 participants (300 couples) enrolled in a randomized controlled trial (RCT) conducted between May 2009 and February 2013...
January 27, 2018: International Journal on Drug Policy
Conall O'Cleirigh, David W Pantalone, Abigail W Batchelder, Mark L Hatzenbuehler, Samantha M Marquez, Chris Grasso, Steven A Safren, Kenneth H Mayer
Sexual orientation related health disparities are well documented. Sexual minority men appear to be at risk for mental health problems due to the stress they experience in establishing and maintaining a minority sexual identity. These mental health issues may combine synergistically and lead to higher medical costs to society. We examine whether sexual minority specific syndemic indicators were associated with higher health care costs, health care utilization, or the risk of being HIV-infected. Health care consumers at a community health center (N = 1211) completed a brief screening questionnaire collected over 12 months...
February 6, 2018: Journal of Behavioral Medicine
Jocelyn C Anderson, Jacquelyn C Campbell, Nancy E Glass, Michele R Decker, Nancy Perrin, Jason Farley
The substance abuse, violence and HIV/AIDS (SAVA) syndemic represents a complex set of social determinants of health that impacts the lives of women. Specifically, there is growing evidence that intimate partner violence (IPV) places women at risk for both HIV acquisition and poorer HIV-related outcomes. This study assessed prevalence of IPV in an HIV clinic setting, as well as the associations between IPV, symptoms of depression and PTSD on three HIV-related outcomes-CD4 count, viral load, and missed clinic visits...
April 2018: AIDS Care
Jason S Melo, Maria Luisa Mittal, Danielle Horyniak, Steffanie A Strathdee, Dan Werb
BACKGROUND: Dual epidemics of injection drug use and blood-borne disease, characterized as "syndemics," are present in a range of settings. Behaviors that drive such syndemics are particularly prevalent among mobile drug-using populations, for whom cross-border migration may pose additional risks. OBJECTIVES: This narrative review aims to characterize the risk factors for injection drug use initiation associated with migration, employing a risk environment framework and focusing on the San Diego-Tijuana border region as the most dynamic example of these phenomena...
January 24, 2018: Substance Use & Misuse
Camilla Ida Ravnbøl
This study investigates health concerns and access to health services for Roma from Romania who live in homelessness in Copenhagen, Denmark. They collect refundable bottles and call themselves "badocari," which in Romanian refers to "people who work with bottles." Homeless Roma in Denmark have not previously been studied through ethnographic research. The study stresses the importance of a syndemic approach towards understanding badocari health concerns. Syndemics is understood as co-occurring diseases, which unfold within contexts of social injustice...
December 2017: Health and Human Rights
David Córdova, Justin E Heinze, Hsing-Fang Hsieh, Ritesh Mistry, Christopher P Salas-Wright, Stephanie H Cook, Marc A Zimmerman
OBJECTIVES: To examine trajectories of adolescent psychosocial risk - drug use, depressive and anxiety symptoms, and violence victimization and observation - and the longitudinal relationship between psychosocial risk trajectories during adolescence and HIV risk behaviors in adulthood. METHODS: The 18-year longitudinal study was conducted from September 1994 through May 2013, in Michigan. Eight hundred and fifty predominantly (80%) African-American adolescents completed demographics and measures of drug use, depressive and anxiety symptoms, violence victimization and observation at Times 1-4, sexual risk behaviors at Times 5 and 6, and social conditions (i...
February 20, 2018: AIDS
Kiyomi Tsuyuki, Jessica D Gipson, Regina Maria Barbosa, Lianne A Urada, Donald E Morisky
Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency...
December 12, 2017: Culture, Health & Sexuality
Zezhou Wang, Xu Zhao, Zhan Zhang, Mengyun Luo, Qiuming Shen, Yuanyuan Dong, Ying Wang, Yong Cai
We aimed to apply syndemic theory to verify the association and reinforcing effects between psychosocial problems and multiple sexual partners (MSP) of men who have sex with men (MSM) in Shanghai, China. A cross-sectional study was conducted among 547 MSM in Shanghai, China using a face-to-face survey. Sociodemographic and psychosocial data were collected, as well as information on MSP and condomless anal sex. In the 6 months prior to the survey, 54.3% of the MSM sample had had MSP. Univariate analysis showed that self-esteem, depression, loneliness, sexual compulsivity, and involuntary subordination (IS) were associated with MSP...
December 8, 2017: Journal of Sex Research
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