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Syndemics and HIV-related sexual risk among men who have sex with men in India: influences of stigma and resilience
Open accessAbstract
Using syndemics theory as a framework, we explored the experience of men who have sex with men in India in relation to four syndemic conditions (depression, alcohol use, internalised homonegativity and violence victimisation) and to understand their resilience resources. Five focus groups were conducted among a purposive sample of diverse men along with seven key informant interviews with HIV service providers. Participants' narratives suggested various pathways by which syndemic conditions interact with one another to sequentially or concurrently increase HIV risk. Experiences of discrimination and violence from a range of perpetrators (family, ruffians and police) contributed to internalised homonegativity and/or depression, which in turn led some men to use alcohol as a coping strategy. Stigma related to same-sex sexuality, gender non-conformity and sex work contributed to the production of one or more syndemic conditions. While rejection by family and male regular partners contributed to depression/alcohol use, support from family, regular partners and peers served as resources of resilience. In India, HIV prevention and health promotion efforts among men who have sex with men could be strengthened by multi-level multi-component interventions to reduce intersectional/intersecting stigma, address syndemic conditions and foster resilience - especially by promoting family acceptance and peer support.
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Larger social forces like negative attitudes toward same-sex attracted persons and criminalisation of consensual adult same-sex intercourse contribute to violence victimisation and indirectly lead to alcohol and drug use through internalised homonegativity and depression.
“Given that larger social forces like negative attitudes toward same-sex attracted persons and criminalisation of consensual adult same-sex intercourse contribute to violence victimisation and indirectly lead to alcohol and drug use through internalised homonegativity and depression (Chakrapani et al., 2018, Meyer, 2003, Stall et al., 2008, Starks et al., 2013)”
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 Chakrapani et al., 2018
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Hatcher, A. M., Gibbs, A., McBride, R.-S., Rebombo, D., Khumalo, M., & Christofides, N. J. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.112637 · Cited by 90
Syndemics: A Cross-Disciplinary Approach to Complex Epidemic Events Like COVID-19
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“Given that larger social forces like negative attitudes toward same-sex attracted persons and criminalisation of consensual adult same-sex intercourse contribute to violence victimisation and indirectly lead to alcohol and drug use through internalised homonegativity and depression (Chakrapani et al., 2018; Meyer, 200…”
BackgroundSelf-citationRecommendations for empirical syndemics analyses: A stepwise methodological guide
Bulled, N. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e38931 · Cited by 6
Metadata
- Authors
- Chakrapani, V., Kaur, M., Newman, P. A., Mittal, S., & Kumar, R.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- University of Toronto (CA)
- Chandigarh State AIDS Control Society, Chandigarh, India
- Corresponding author
- Kaur, Manmeet
- Venue
- Culture, Health & Sexuality
- Publisher
- Informa UK Limited
- Published
- 2018-07-20
- Volume
- 21
- Issue
- 4
- Pages
- 416-431
- ISSN
- 1369-1058 (ISSN-L)
- 1464-5351
- PMC
- PMC6430415
- OpenAlex
- W2884252078
- Cited by
- 53
- References
- 2
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 8 · 2023: 13 · 2022: 6 · 2021: 7 · 2020: 8 · 2019: 3 · 2018: 1
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Culture Health & Sexuality (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- DBT India Alliance (IA/CPHS/16/1/502667)
- 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
- syndemic, HIV risk, men who have sex with men, depression, alcohol consumption, violent victimization, stigma, resilience, family rejection, peer support, HIV prevention, India
- MeSH terms
- Syndemic, Adult, Humans, Male, Sexual Behavior, HIV Infections, Focus Groups, Homosexuality, Male, Resilience, Psychological, Social Stigma
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