Social Networks Moderate the Syndemic Effect of Psychosocial and Structural Factors on HIV Risk Among Young Black Transgender Women and Men who have Sex with Men


The interaction between the cumulative effect of psychosocial and structural factors (i.e. syndemic effect) and social networks among young Black transgender women and men who have sex with men (YBTM) remains understudied. A representative cohort of 16–29 year-old YBTM (n = 618) was assessed for syndemic factors [i.e. substance use; community violence; depression; poverty; justice system involvement (JSI)], social network characteristics, condomless anal sex (CAS), group sex (GS), and HIV-infection. The syndemic index significantly increased the odds of CAS, GS, and HIV-infection, and these effects were moderated by network characteristics. Network JSI buffered the effect on CAS, romantic network members buffered the effect on GS, and network age and proportion of family network members buffered the effect on HIV-infection. The proportion of friend network members augmented the effect on GS and HIV-infection. Future research to prevent HIV among YBTM should consider social network approaches that target both structural and psychosocial syndemic factors.

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The authors would like to recognize the study participants who provided significant time and insight into their lives. In addition, the authors would like to recognize the staff at the Chicago Center for HIV Elimination, as well as Phil Schumm, Britt Livak, Ethan Morgan and Rita Rossi-Foulkes. This work received funding from the National Institutes of Health grants 1R01DA033875 and R01DA039934. This publication was made possible with help from the Third Coast Center for AIDS Research (CFAR), an NIH funded center (P30 AI117943).

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Teixeira da Silva, D., Bouris, A., Voisin, D. et al. Social Networks Moderate the Syndemic Effect of Psychosocial and Structural Factors on HIV Risk Among Young Black Transgender Women and Men who have Sex with Men. AIDS Behav 24, 192–205 (2020).

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  • Black
  • Transgender women
  • MSM
  • HIV
  • Syndemic