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Pathways towards Risk: Syndemic Conditions Mediate the Effect of Adversity on HIV Risk Behaviors among Young Men Who Have Sex with Men (YMSM)

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Abstract

Research shows that young men who have sex with men (YMSM) engage in higher rates of health risk behaviors and experience higher rates of negative health outcomes than their peers. The purpose of this study is to determine if the effects of adversity on HIV risk are mediated by syndemics (co-occurring health problems). Participants were 470 ethnically diverse YMSM ages 18 to 24 recruited between 2005 and 2006 and surveyed every 6 months for 24 months. Regression analyses examined the impact of adversity on syndemics (emotional distress, substance use, and problematic alcohol use) and the effects of both adversity and syndemics on HIV risk behaviors over time. Gay-related discrimination and victimization—among other adversity variables—were significantly associated with syndemics and condomless sex (CS). Syndemics mediated the effects of adversity on CS in all models. Adverse events impact HIV risk taking among YMSM through syndemics. These findings suggest that prevention programs aimed at reducing adversity may reduce both the synergistic effect of multiple psychosocial health problems and HIV risk taking.

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Acknowledgments

Support for this study was provided by the National Institute of Drug Abuse (R01 DA015638-03) and by the National Institute of Mental Health (1 F31 MH087238-01A1). We thank the HYM study team and the PITT Public Health Behavioral HIV team for their contribution to this study. Most importantly, we would sincerely like to thank the young men who have participated for their immense contribution to HIV research.

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Authors and Affiliations

  1. Graduate school of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA

    Amy Herrick, Ron Stall, James Egan, Sheree Schrager & Michele Kipke

Authors
  1. Amy Herrick
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  2. Ron Stall
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  3. James Egan
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  4. Sheree Schrager
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  5. Michele Kipke
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Correspondence to Amy Herrick.

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Herrick, A., Stall, R., Egan, J. et al. Pathways towards Risk: Syndemic Conditions Mediate the Effect of Adversity on HIV Risk Behaviors among Young Men Who Have Sex with Men (YMSM). J Urban Health 91, 969–982 (2014). https://doi.org/10.1007/s11524-014-9896-1

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  • DOI: https://doi.org/10.1007/s11524-014-9896-1

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