Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia
Introduction: Men who have sex with men (MSM) and transgender women (TW) in Colombia are highly affected by HIV. To improve understanding of the role of HIV risk behaviors in HIV acquisition, we used the syndemic framework, a useful concept to inform prevention efforts. Objective: To examine the eff...
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doaj-105e1b87d62f4214aa109c9ff1ef74942020-11-25T02:37:15ZengInstituto Nacional de SaludBiomédica: revista del Instituto Nacional de Salud0120-41572020-06-0140239140310.7705/biomedica.50825082Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in ColombiaBeatriz Alvarado0Hector Fabio Mueses1Jaime Galindo2Jorge Luis Martínez-Cajas3Department of Public Health Sciences, Queens University, Kingston, CanadaCorporación de Lucha contra el SIDA, Cali, ColombiaCorporación de Lucha contra el SIDA, Cali, ColombiaDepartment of Medicine, Division of infectious Diseases, Queen’s University, Kingston, CanadaIntroduction: Men who have sex with men (MSM) and transgender women (TW) in Colombia are highly affected by HIV. To improve understanding of the role of HIV risk behaviors in HIV acquisition, we used the syndemic framework, a useful concept to inform prevention efforts. Objective: To examine the effect of four psychosocial conditions, namely, forced sex, history of childhood sexual abuse, frequent alcohol use, and illicit drug use on unprotected sex and the synergistic effects (“syndemic” effects) of these conditions on HIV risk behavior. Materials and methods: We enrolled a total of 812 males (54.7% men who have sex with men, MSM; 7.3% transgender women, and 38% non-MSM). The participants were recruited from neighborhoods of low socioeconomic status through free HIV-counseling and -testing campaigns. We performed Poisson regression analysis to test the associations and interactions between the four psychosocial conditions and unprotected sex with regular, occasional, and transactional partners. To test the “syndemic” model, we assessed additive and multiplicative interactions. Results: The prevalence of any psychosocial condition was 94.9% in transgender women, 60.1% in MSM, and 72.2% in non-MSM. A higher likelihood of transactional sex was associated in MSM (prevalence ratio (PR)=7.41, p<0.001) and non-MSM (PR=2.18, p< 0.001) with three or all four conditions compared to those with one condition. Additive interactions were present for all combinations of psychosocial problems on transactional sex n MSM. No cumulative effect or additive interaction was observed in transgender women. Conclusions: Our study highlights the need for bundled mental health programs addressing childhood sexual abuse, illicit drug use, and frequent alcohol use with other HIV prevention programs.https://revistabiomedica.org/index.php/biomedica/article/view/5082“syndemic”hivunsafe sexsexual and gender minorities |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Beatriz Alvarado Hector Fabio Mueses Jaime Galindo Jorge Luis Martínez-Cajas |
spellingShingle |
Beatriz Alvarado Hector Fabio Mueses Jaime Galindo Jorge Luis Martínez-Cajas Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia Biomédica: revista del Instituto Nacional de Salud “syndemic” hiv unsafe sex sexual and gender minorities |
author_facet |
Beatriz Alvarado Hector Fabio Mueses Jaime Galindo Jorge Luis Martínez-Cajas |
author_sort |
Beatriz Alvarado |
title |
Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia |
title_short |
Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia |
title_full |
Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia |
title_fullStr |
Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia |
title_full_unstemmed |
Application of the “syndemics” theory to explain unprotected sex and transactional sex: A crosssectional study in men who have sex with men (MSM), transgender women, and non-MSM in Colombia |
title_sort |
application of the “syndemics” theory to explain unprotected sex and transactional sex: a crosssectional study in men who have sex with men (msm), transgender women, and non-msm in colombia |
publisher |
Instituto Nacional de Salud |
series |
Biomédica: revista del Instituto Nacional de Salud |
issn |
0120-4157 |
publishDate |
2020-06-01 |
description |
Introduction: Men who have sex with men (MSM) and transgender women (TW) in Colombia are highly affected by HIV. To improve understanding of the role of HIV risk behaviors in HIV acquisition, we used the syndemic framework, a useful concept to inform prevention efforts.
Objective: To examine the effect of four psychosocial conditions, namely, forced sex, history of childhood sexual abuse, frequent alcohol use, and illicit drug use on unprotected sex and the synergistic effects (“syndemic” effects) of these conditions on HIV risk behavior.
Materials and methods: We enrolled a total of 812 males (54.7% men who have sex with men, MSM; 7.3% transgender women, and 38% non-MSM). The participants were recruited from neighborhoods of low socioeconomic status through free HIV-counseling and -testing campaigns. We performed Poisson regression analysis to test the associations and interactions between the four psychosocial conditions and unprotected sex with regular, occasional, and transactional partners. To test the “syndemic” model, we assessed additive and multiplicative interactions.
Results: The prevalence of any psychosocial condition was 94.9% in transgender women, 60.1% in MSM, and 72.2% in non-MSM. A higher likelihood of transactional sex was associated in MSM (prevalence ratio (PR)=7.41, p<0.001) and non-MSM (PR=2.18, p< 0.001) with three or all four conditions compared to those with one condition. Additive interactions were present for all combinations of psychosocial problems on transactional sex n MSM. No cumulative effect or additive interaction was observed in transgender women.
Conclusions: Our study highlights the need for bundled mental health programs addressing childhood sexual abuse, illicit drug use, and frequent alcohol use with other HIV prevention programs. |
topic |
“syndemic” hiv unsafe sex sexual and gender minorities |
url |
https://revistabiomedica.org/index.php/biomedica/article/view/5082 |
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