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“Outness” as a Moderator of the Association Between Syndemic Conditions and HIV Risk-Taking Behavior Among Men Who Have Sex with Men in Tijuana, Mexico

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Abstract

Multiple psychosocial conditions tend to co-occur and contribute to higher risk for HIV among men who have sex with men (MSM), a phenomenon known as syndemics. Less is known about moderating factors that may attenuate the relation between syndemic conditions and sexual risk-taking. We examined disclosure of same-sex sexual behavior or “outness” as a moderating factor of the syndemic effect. We recruited a sample of MSM (n = 191) using respondent-driven sampling in Tijuana, Mexico. Participants completed a survey of syndemic conditions (i.e., substance use, depression, violence, internalized homophobia, and sexual compulsivity), sexual risk-taking (i.e., condom unprotected anal sex with a stranger in the past 2 months), and the degree to which they are “out” about sex with men. Consistent with previous research, we found that men who report more syndemic conditions show a greater prevalence of sexual risk-taking. As predicted, men who were out to more people showed a weaker association between syndemic conditions and sexual risk-taking, whereas men who were out to fewer people showed the strongest association. This study is the first to provide evidence of “outness” as a moderating factor that attenuates syndemic effects on sexual risk-taking. Building upon previous research, the data suggest that “outness” may be a resilience factor for MSM in Tijuana. HIV prevention intervention implications are discussed.

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Acknowledgment

This study was funded by an AIDS International Training in Research seed grant (AITRP) awarded to DG. Preparation of this manuscript was supported by a National Institute on Drug Abuse (NIDA) K01 Mentored Career Development Award (K01 DA036447-01) to EVP, and a NIDA training fellowship T32DA023356 to LRS.

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Authors and Affiliations

  1. Division of Global Public Health, Department of Medicine, University of California at San Diego, Mail Code 0507, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA

    Eileen V. Pitpitan, Laramie R. Smith, David Goodman-Meza, Shirley J. Semple & Steffanie A. Strathdee

  2. Agencia Familiar Binacional, A.C., Tijuana, Mexico

    Karla Torres

  3. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Thomas L. Patterson

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  1. Eileen V. Pitpitan
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Correspondence to Eileen V. Pitpitan.

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Pitpitan, E.V., Smith, L.R., Goodman-Meza, D. et al. “Outness” as a Moderator of the Association Between Syndemic Conditions and HIV Risk-Taking Behavior Among Men Who Have Sex with Men in Tijuana, Mexico. AIDS Behav 20, 431–438 (2016). https://doi.org/10.1007/s10461-015-1172-1

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