AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #73 - Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic
Authors: Presenting Author: Dr Jeffrey Parsons - Hunter College
Additional Authors: Dr. Christian Grov, Dr. Sarit Golub,
Aim: We evaluated the extent to which Sexual Compulsivity (SC) fits into the syndemics framework: a nexus of co-occurring psychosocial health problems that increase HIV risk among gay and bisexual men.
Method / Issue: We conducted a cross-sectional community-based survey of gay and bisexual men in New York City (n = 669). Brief street-intercept survey methods were used to survey men attending gay/bisexual community events.
Results / Comments: We found strong positive interrelationships among syndemic factors including SC, depression, childhood sexual abuse, intimate partner violence, and polydrug use. For example, men who were experiencing symptoms of SC had 3.95 times the odds to be depressed, 2.20 times the odds to have experienced childhood sexual abuse, and 2.56 times the odds to have experienced intimate partner violence in the past five years. In bivariate analyses, all syndemic health problems except for childhood sexual abuse were significantly positively related to HIV seropositivity and high-risk sex. In a series of multivariable models, we found an array of interrelationships among psychosocial health problems. We found amplified effects of the five psychosocial health problems on HIV seropositivity and on the likelihood of engaging in high-risk sex. Greater numbers of health problems were significantly and positively associated with HIV infection and current high-risk sex. For example, 4.7% of men experiencing no psychosocial health problems were HIV positive, versus 11.4% of those reporting one problem, 13.2% of those who reported two problems, and 25.4% of men reporting three or greater problems. For both HIV seropositivity and high-risk sex the Mantel-Haenszel tests for linear-by-linear association were significant at p < .001 (Gamma HIV seropositivty = .41, p < .001; Gamma high-risk sex = .41, p < .001). Interpreting Gamma, approximately 41% of the variance in both HIV seropositivity and high-risk sex is explained by the number of psychosocial health problems. A greater number of psychosocial health problems was associated with ascending odds ratios for high-risk sex (Adj. OR = 1.65, 95% CI = 1.32 – 2.07, p < .001) and ascending prevalence rates for HIV seropositivity (Adj. OR = 1.63, 95% CI = 1.30 – 2.05, p < .001).
Discussion: Findings provide further support of a syndemics framework for HIV risk among gay and bisexual men. SC fits well as an additional component of this framework. HIV prevention interventions should consider overlapping/compounding effects of negative psychosocial problems, including SC.
Go Back