title: Syndemic vulnerability, sexual and injection risk behaviors, and HIV continuum of care outcomes in HIV-positive injection drug users.
abstract: Limited investigations have been conducted on syndemics and HIV continuum of care outcomes. Using baseline data from a multi-site, randomized controlled study of HIV-positive injection drug users (n = 1,052), we examined whether psychosocial factors co-occurred, and whether these factors were additively associated with behavioral and HIV continuum of care outcomes. Experiencing one type of psychosocial problem was significantly (p < 0.05) associated with an increased odds of experiencing another type of problem. Persons with 3 or more psychosocial problems were significantly more likely to report sexual and injection risk behaviors and were less likely to be adherent to HIV medications. Persons with 4 or more problems were less likely to be virally suppressed. Reporting any problems was associated with not currently taking HIV medications. Our findings highlight the association of syndemics not only with risk behaviors, but also with outcomes related to the continuum of care for HIV-positive persons.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE Mail Stop E37, Atlanta, GA, 30333, USA, ybm2@cdc.gov.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mizuno
authors.forename: David W
authors.initials: DW
authors.lastname: Purcell
authors.forename: Amy R
authors.initials: AR
authors.lastname: Knowlton
authors.forename: James D
authors.initials: JD
authors.lastname: Wilkinson
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Knight
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016485:Needle Sharing; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications*; D047568:Unsafe Sex