Article

Journal of Urban Health

, Volume 89, Issue 4, pp 697-708

First online:

Application of Syndemic Theory to Black Men Who Have Sex with Men in the Multicenter AIDS Cohort Study

  • Typhanye Penniman DyerAffiliated withDepartment of Epidemiology and Biostatistics, School of Public Health, University of Maryland Email author 
  • , Steve ShoptawAffiliated withDepartment of Family Medicine, University of California Los Angeles
  • , Thomas E. GuadamuzAffiliated withDepartment of Behavioral and Community Health Sciences, University of Pittsburgh
  • , Michael PlankeyAffiliated withDepartment of Medicine, Division of Infectious Diseases, Georgetown University Medical Center
  • , Uyen KaoAffiliated withDepartment of Family Medicine, University of California Los Angeles
  • , David OstrowAffiliated withNational Opinion Research Center, University of Chicago
  • , Joan S. ChmielAffiliated withFeinberg School of Medicine, Northwestern University
  • , Amy HerrickAffiliated withDepartment of Behavioral and Community Health Sciences, University of Pittsburgh
  • , Ron StallAffiliated withDepartment of Behavioral and Community Health Sciences, University of Pittsburgh

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

This study analyzed data from a large prospective epidemiologic cohort study among men who have sex with men (MSM), the Multicenter AIDS Cohort Study, to assess syndemic relationships among Black MSM in the cohort (N = 301). We hypothesized that multiple interconnections among psychosocial health conditions would be found among these men, defining syndemic conditions. Constituents of syndemic conditions measured included reported depression symptoms, sexual compulsiveness, substance use, intimate partner violence (IPV), and stress. We found significant evidence of syndemics among these Black men: depression symptoms were independently associated with sexual compulsiveness (odds ratios [OR]: 1.88, 95% CI = 1.1, 3.3) and stress (OR: 2.67, 95% CI = 1.5, 4.7); sexual compulsiveness was independently associated with stress (OR: 2.04, 95% CI = 1.2, 3.5); substance misuse was independently associated with IPV (OR: 2.57, 95% CI = 1.4, 4.8); stress independently was associated with depression symptoms (OR: 2.67, 95% CI = 1.5, 4.7), sexual compulsiveness (OR: 2.04, 95% CI = 1.2, 3.5) and IPV (OR: 2.84, 95% CI = 1.6, 4.9). Moreover, men who reported higher numbers of syndemic constituents (three or more conditions) reportedly engaged in more unprotected anal intercourse compared to men who had two or fewer health conditions (OR: 3.46, 95% CI = 1.4–8.3). Findings support the concept of syndemics in Black MSM and suggest that syndemic theory may help explain complexities that sustain HIV-related sexual transmission behaviors in this group.

Keywords

HIV Syndemics Black men Sexual risk Epidemiology