Journal of Urban Health

, Volume 89, Issue 4, pp 697–708 | Cite as

Application of Syndemic Theory to Black Men Who Have Sex with Men in the Multicenter AIDS Cohort Study

  • Typhanye Penniman Dyer
  • Steve Shoptaw
  • Thomas E. Guadamuz
  • Michael Plankey
  • Uyen Kao
  • David Ostrow
  • Joan S. Chmiel
  • Amy Herrick
  • Ron Stall


This study analyzed data from a large prospective epidemiologic cohort study among men who have sex with men (MSM), the Multicenter AIDS Cohort Study, to assess syndemic relationships among Black MSM in the cohort (N = 301). We hypothesized that multiple interconnections among psychosocial health conditions would be found among these men, defining syndemic conditions. Constituents of syndemic conditions measured included reported depression symptoms, sexual compulsiveness, substance use, intimate partner violence (IPV), and stress. We found significant evidence of syndemics among these Black men: depression symptoms were independently associated with sexual compulsiveness (odds ratios [OR]: 1.88, 95% CI = 1.1, 3.3) and stress (OR: 2.67, 95% CI = 1.5, 4.7); sexual compulsiveness was independently associated with stress (OR: 2.04, 95% CI = 1.2, 3.5); substance misuse was independently associated with IPV (OR: 2.57, 95% CI = 1.4, 4.8); stress independently was associated with depression symptoms (OR: 2.67, 95% CI = 1.5, 4.7), sexual compulsiveness (OR: 2.04, 95% CI = 1.2, 3.5) and IPV (OR: 2.84, 95% CI = 1.6, 4.9). Moreover, men who reported higher numbers of syndemic constituents (three or more conditions) reportedly engaged in more unprotected anal intercourse compared to men who had two or fewer health conditions (OR: 3.46, 95% CI = 1.4–8.3). Findings support the concept of syndemics in Black MSM and suggest that syndemic theory may help explain complexities that sustain HIV-related sexual transmission behaviors in this group.


HIV Syndemics Black men Sexual risk Epidemiology 


Sources of support

The Multicenter AIDS Cohort Study is funded by the National Institute of Allergy and Infectious Diseases, with additional supplemental funding from the National Cancer Institute, and the National Heart, Lung, and Blood Institute: U01-AI-35042, 5-M01-RR-00052 (GCRC), U01-AI-35043, U01-AI-37984, U01-AI-35039, U01-AI-35040, U01-AI-37613, and U01-AI-35041. Additional support was provided by the National Institute of Drug Abuse through 1 R01 DA022936, “Long Term Health Effects of Methamphetamine Use in the MACS,” Ronald Stall, Ph.D., PI, 5 P30 MH058107, “Intervention Core for the Center for HIV Identification, Prevention and Treatment Services,” Steve Shoptaw Co-PI, T32 DA007292-17, William Latimer, PI and R25 MH080664, Gail Wyatt, PI, USA.


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Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • Typhanye Penniman Dyer
    • 1
  • Steve Shoptaw
    • 2
  • Thomas E. Guadamuz
    • 3
  • Michael Plankey
    • 4
  • Uyen Kao
    • 2
  • David Ostrow
    • 5
  • Joan S. Chmiel
    • 6
  • Amy Herrick
    • 3
  • Ron Stall
    • 3
  1. 1.Department of Epidemiology and Biostatistics, School of Public HealthUniversity of MarylandCollege ParkUSA
  2. 2.Department of Family MedicineUniversity of California Los AngelesLos AngelesUSA
  3. 3.Department of Behavioral and Community Health SciencesUniversity of PittsburghPittsburghUSA
  4. 4.Department of Medicine, Division of Infectious DiseasesGeorgetown University Medical CenterWashingtonUSA
  5. 5.National Opinion Research CenterUniversity of ChicagoChicagoUSA
  6. 6.Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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