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HIV Syndemics

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HIV Psychiatry

Abstract

The preceding chapters have demonstrated that the HIV/AIDS epidemic is not solely a biomedical entity but rather a narrative of vulnerability and illness that is exacerbated by social marginalization, particularly in populations with an excess burden of illness. In vulnerable individuals, the HIV/AIDS epidemic is often a component of multiple synergistically interacting epidemics that give rise to disparities in both the component and other negative health outcomes, with this phenomenon being described as a syndemic. Syndemics describe excess cases of illness that cluster together as a result of deleterious biosocial interactions. Syndemogenesis, or the evolution of syndemics, has been proposed as a framework for understanding the excess burden of disease observed in populations. From the outset to the present, the HIV/AIDS epidemic continues to underscore that context is all-important: HIV exposure, transmission, comorbidity, and clustering embody the sequelae of deleterious interactions of social factors with biological illness in at-risk populations. To this end, the conventional biomedical paradigm limits a more fulsome understanding of the sociocultural and geopolitical factors that drive the disease and shape the needs of persons affected by and infected with the illness. A syndemic lens can enrich and better inform community leaders, public health planners, and healthcare providers. The ongoing recognition of multiple HIV/AIDS syndemics is arguably indicative that conventional approaches to healthcare for people living with HIV/AIDS are reductive, and suggests a need for reformulating care to better meet the needs of people living with HIV/AIDS. Addressing the excess burden of illness in vulnerable populations requires recognition that HIV/AIDS is a psychosocially bound epidemic at each level, from the cellular to the individual to the population level. This chapter will examine HIV/AIDS utilizing a syndemic framework, describe some key syndemics, explore the benefits and challenges of adopting this framework, and propose future directions for prevention utilizing a syndemic lens.

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Abbreviations

SAVA:

Substance abuse violence and HIV/AIDS

STI:

Sexually transmitted infection

TB:

Tuberculosis

VIDDA:

Violence, immigration, depression, type 2 diabetes mellitus, and abuse

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Author information

Authors and Affiliations

  1. Department of Psychiatry, St. Joseph’s Health Centre, Toronto, ON, Canada

    Mariam Abdurrahman

  2. Consultation-Liaison Psychiatry Service, Columbia University Irving Medical Center, New York, NY, USA

    Luis F. Pereira

  3. Department of Psychiatry, NYU School of Medicine, New York, NY, USA

    Mark V. Bradley

Authors
  1. Mariam Abdurrahman
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  2. Luis F. Pereira
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  3. Mark V. Bradley
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Corresponding author

Correspondence to Mariam Abdurrahman .

Editor information

Editors and Affiliations

  1. Baylor Scott & White Health, Texas A&M University, Temple, TX, USA

    James A. Bourgeois

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mary Ann Adler Cohen

  3. School of Medicine, Georgetown University, District of Columbia, Washington, DC, USA

    Getrude Makurumidze

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Abdurrahman, M., Pereira, L.F., Bradley, M.V. (2022). HIV Syndemics. In: Bourgeois, J.A., Cohen, M.A.A., Makurumidze, G. (eds) HIV Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-80665-1_14

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  • DOI: https://doi.org/10.1007/978-3-030-80665-1_14

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