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Cited by 88HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskLGBTQ Health, Identity, and Policy

Psychosocial health conditions and HIV prevalence and incidence in a cohort of men who have sex with men in Bangkok, Thailand: Evidence of a syndemic effect

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Guadamuz, T. E., McCarthy, K., Wimonsate, W., Thienkrua, W., Varangrat, A., Chaikummao, S., Sangiamkittikul, A., Stall, R. D. +1 more·2014·AIDS and Behavior
DOI 10.1007/s10461-014-0826-8PMC PMC4198419
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Abstract

Men who have sex with men (MSM) in Bangkok may experience multiple psychosocial health conditions, such as substance use, suicidality, and a history of sexual abuse. These factors may contribute to HIV vulnerability in a syndemic way. A syndemic is defined as a number of synergistically interacting health conditions producing excess disease in a population. The objective of this study is to examine whether psychosocial health conditions among MSM have a syndemic association with HIV prevalence and HIV incidence. To do this, we evaluated psychosocial health conditions and their associations with unprotected sex, HIV prevalence and HIV incidence in a cohort of Thai MSM (N = 1,292). There was a positive and significant association between the number of psychosocial health conditions and increased levels of unprotected sex and HIV prevalence at study baseline. The number of psychosocial health conditions at baseline was also associated with increased HIV incidence during follow-up (no conditions, HIV incidence = 15.3 %; one to three conditions, 23.7 %; four to five conditions, 33.2 %). The number of psychosocial health conditions was positively associated with HIV risk behavior and HIV prevalence and incidence. Prevention efforts among MSM need to address the existence of multiple psychosocial health conditions and their synergy to effectively decrease the spread of HIV infection.

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  • Most studies of HIV-related syndemics, especially among MSM, have attempted and failed to test the hypothesis that co-occurring epidemics synergistically interact.

    “Most studies of HIV-related syndemics, especially among MSM, have attempted – and failed – to test the hypothesis that co-occurring epidemics (i.e., of alcohol use, violence victimisation, etc.) synergistically interact (Guadamuz et al., 2014, Stall et al., 2003, Tomori et al., 2018).”

    From The syndemic of violence victimisation, drug use, frequent alcohol use, and HIV transmission risk behaviour among men who have sex with men: Cross-sectional, population-based study in India (2019) · cites this paper as Guadamuz et al., 2014

    The Discussion (page unavailable) says this study explored possible synergistic effects using a syndemic count, while acknowledging that a count variable cannot assess interactions between its components. That supports the concern about testing synergy, but the paper does not establish that most HIV-related syndemics studies attempted and failed to test it. (LLM, conf=0.84)

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Authors
Guadamuz, T. E., McCarthy, K., Wimonsate, W., Thienkrua, W., Varangrat, A., Chaikummao, S., Sangiamkittikul, A., Stall, R. D., & van Griensven, F.
Affiliations
  • Mahidol University (TH)
  • Centers for Disease Control and Prevention (US)
  • University of Pittsburgh (US)
Corresponding author
Guadamuz, T. E.
ORCID
Venue
AIDS and Behavior
Publisher
Springer Science and Business Media LLC
Published
2014-07-03
Volume
18
Issue
11
Pages
2089-2096
ISSN
  • 1090-7165 (ISSN-L)
  • 1573-3254
DOI
10.1007/s10461-014-0826-8
PMC
PMC4198419
OpenAlex
W2097698027
Cited by
88
References
58
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 16 · 2020: 7 · 2019: 10 · 2018: 15 · 2017: 7 · 2016: 2 · 2015: 10 · 2014: 5
FWCI
5.62
Type
journal article
Language
en
Open access
Licence
Locations
  • AIDS and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Association of Schools and Programs of Public Health
  • Centers for Disease Control and Prevention
  • National Institute of Mental Health (K01MH085567)
  • National Institute on Drug Abuse (L30 DA034576)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
men who have sex with men, HIV prevalence, HIV incidence, syndemic, substance use, suicidality, sexual abuse history, unprotected sex, HIV risk behavior, Bangkok
MeSH terms
Adult, Humans, Longitudinal Studies, Male, Psychology, Risk Factors, Thailand, Cohort Studies, HIV Infections, Incidence, Prevalence, Homosexuality, Male, Unsafe Sex, Kaplan-Meier Estimate

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