Annals of Behavioral Medicine

, Volume 45, Issue 2, pp 153–162

Co-occurring Psychosocial Problems and HIV Risk Among Women Attending Drinking Venues in a South African Township: A Syndemic Approach

  • Eileen V. Pitpitan
  • Seth C. Kalichman
  • Lisa A. Eaton
  • Demetria Cain
  • Kathleen J. Sikkema
  • Melissa H. Watt
  • Donald Skinner
  • Desiree Pieterse
Original Article



In South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied in understanding HIV risk among marginalized groups.


The purposes of this study are to apply the syndemic framework to examine psychosocial problems that co-occur among women attending drinking venues in South Africa and to test how the co-occurrence of these problems may exacerbate risk for HIV infection.


Five hundred sixty women from a Cape Town township provided data on multiple psychosocial problems, including food insufficiency, depression, abuse experiences, problem drinking, and sexual behaviors.


Bivariate associations among the syndemic factors showed a high degree of co-occurrence and regression analyses showed an additive effect of psychosocial problems on HIV risk behaviors.


These results demonstrate the utility of a syndemic framework to understand co-occurring psychosocial problems among women in South Africa. HIV prevention interventions should consider the compounding effects of psychosocial problems among women.


HIV risk Sexual risk behavior Syndemics Mental health Abuse Alcohol 


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Copyright information

© The Society of Behavioral Medicine 2012

Authors and Affiliations

  • Eileen V. Pitpitan
    • 1
  • Seth C. Kalichman
    • 1
  • Lisa A. Eaton
    • 1
  • Demetria Cain
    • 1
  • Kathleen J. Sikkema
    • 2
  • Melissa H. Watt
    • 2
  • Donald Skinner
    • 3
  • Desiree Pieterse
    • 3
  1. 1.Center for Health, Intervention and PreventionUniversity of ConnecticutStorrsUSA
  2. 2.Duke UniversityDurhamUSA
  3. 3.Stellenbosch UniversityCape TownSouth Africa

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