title: Evidence of a syndemic among young Canadian gay and bisexual men: uncovering the associations between anti-gay experiences, psychosocial issues, and HIV risk.
abstract: Syndemic has become an important theoretical model toward understanding how psychosocial issues may interact to increase HIV acquisition among gay and bisexual men. We measured the extent to which anti-gay experiences are associated with psychosocial issues, which in turn were hypothesized to have an additive effect on HIV risk, in a sample of Canadian young gay and bisexual men. Sixty-eight percent of men reported at least one form of anti-gay experience. For each additional form of anti-gay experience, our data demonstrated increased likelihood of psychosocial issues. Psychosocial issues had an additive effect, increasing the risk of unprotected intercourse in the last 12 months (doubling the risk for those with 3+ issues OR 1.95 [1.39-2.75]). Overall, our findings suggest that a syndemic is occurring among young Canadian gay and bisexual men, highlighting the need to expand HIV prevention efforts beyond sexual risk, to address stigma and gay men's broader health concerns.
authors.affiliation: Community-Based Research Centre for Gay Men's Health, 234-970 Burrard Street, Vancouver, BC, V6G 1G1, Canada, olivier@cbrc.net.
authors.forename: Olivier
authors.initials: O
authors.lastname: Ferlatte
authors.forename: Travis Salway
authors.initials: TS
authors.lastname: Hottes
authors.forename: Terry
authors.initials: T
authors.lastname: Trussler
authors.forename: Rick
authors.initials: R
authors.lastname: Marchand
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D054526:Men's Health; D020380:Needs Assessment; D012309:Risk-Taking; D012649:Self Concept; D057545:Social Stigma; D011795:Surveys and Questionnaires