title: Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic.
abstract: OBJECTIVE
  We evaluated whether sexual compulsivity fits into a syndemic framework, in which sexual compulsivity is one of a number of co-occurring psychosocial health problems that increase HIV risk among men who have sex with men (MSM).
  
  
  METHODS
  In 2003 and 2004, we conducted an anonymous cross-sectional survey of MSM in New York City (n = 669) by approaching attendees at gay, lesbian, and bisexual community events. We analyzed data by bivariate and multivariate logistic regression.
  
  
  RESULTS
  We found strong positive interrelationships among syndemic factors including sexual compulsivity, depression, childhood sexual abuse, intimate partner violence, and polydrug use. In bivariate analyses, all syndemic health problems except for childhood sexual abuse were positively related to HIV seropositivity and high-risk sexual behavior. Our multivariate models revealed an array of interrelationships among psychosocial health problems. We found amplified effects of these problems on HIV seropositivity and on the likelihood of engaging in high-risk sexual behavior.
  
  
  CONCLUSIONS
  Our findings support the conclusion that sexual compulsivity is a component of a syndemic framework for HIV risk among MSM. HIV prevention interventions should consider the overlapping and compounding effects of psychosocial problems, including sexual compulsivity.
authors.affiliation: Hunter College Center for HIV/AIDS Educational Studies and Training, City University of New York, NY 10065, USA. jeffrey.parsons@hunter.cuny.edu
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
authors.forename: Christian
authors.initials: C
authors.lastname: Grov
authors.forename: Sarit A
authors.initials: SA
authors.lastname: Golub
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003192:Compulsive Behavior / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011584:Psychology; D012309:Risk-Taking; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
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