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Examining the Impact of a Psychosocial Syndemic on Past Six-Month HIV Screening Behavior of Black Men who have Sex with Men in the United States: Results from the POWER Study

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Abstract

Syndemic production theory has been used to explore HIV transmission risk or infections but has not been used to investigate prevention behavior, or with large samples of non-Whites. This analysis is the first to explore the impact of syndemic factors on previous six-month HIV screening behavior among US Black MSM. Data from Promoting Our Worth, Equality and Resilience (POWER) were analyzed from 3294 participants using syndemic variable counts and measures of interaction/synergy. Syndemic variables included: past three-month poly-drug use, depression, last year intimate partner violence, HIV risk and problematic binge drinking. BMSM reporting two syndemic factors were more likely to report screening (AOR = 1.37, 95% CI 1.04–1.80; p = 0.028) with no significant associations for three or more conditions. Measures of joint effect revealed that there were synergies among depression, problematic binge drinking and poly-drug use but these psychosocial factors cannot entirely explain testing patterns and excess disease burden among BMSM.

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Acknowledgements

We thank the Center for Black Equity and local Black Pride organizations for partnering with us to implement POWER, the community based organizations who performed onsite HIV testing on the study’s behalf, the thousands of study participants who volunteered their time to contribute to this research, and members of the POWER Study Team who made data collection possible. The local Black Pride organizations are as follows: D.C. Black Pride, Detroit’s Hotter than July, Houston Splash, In the Life Atlanta, Memphis Black Pride, and Philadelphia Black Pride. The community based organizations who performed onsite HIV testing are as follows: Atlanta: AID Atlanta, AIDS Health Care Foundation, NAESM; Detroit: Community Health Awareness Group, Horizons Project, Unified; Houston: Avenue 360, Houston AIDS Foundation, Positive Efforts; Memphis: Friends for Life; Philadelphia: Access Matters, Philadelphia FIGHT; Washington, D.C.: Us Helping Us.

Funding

The funding agencies had no involvement in the study design, analysis or interpretation of data, the writing of the report, or the decision to submit for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This study was partially supported by the National Institute for Nursing Research (R01NR013865) and a National Institutes of Health training grant (T32MH904174-07).

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Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, suite 400, Atlanta, GA, 30322, USA

    Cristian J. Chandler

  2. Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Leigh A. Bukowski, Derrick D. Matthews, Mary E. Hawk, Nina Markovic, James E. Egan & Ronald D. Stall

  3. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Leigh A. Bukowski, Mary E. Hawk, James E. Egan & Ronald D. Stall

  4. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 363 Rosenau Hall, CB # 7440, Chapel Hill, NC, 27599, USA

    Derrick D. Matthews

  5. Dental Public Health, School of Dental Medicine University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA, 15213, USA

    Nina Markovic

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  1. Cristian J. Chandler
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Correspondence to Cristian J. Chandler.

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There are no conflicts of interest to report for any of this paper’s contributing authors. This original, unpublished manuscript has not been submitted for review to any other journal, and has been read and approved by all co-authors.

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All study procedures were approved by the University of Pittsburgh Institutional Review Board.

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Chandler, C.J., Bukowski, L.A., Matthews, D.D. et al. Examining the Impact of a Psychosocial Syndemic on Past Six-Month HIV Screening Behavior of Black Men who have Sex with Men in the United States: Results from the POWER Study. AIDS Behav 24, 428–436 (2020). https://doi.org/10.1007/s10461-019-02458-z

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