title: Retrospective reports of developmental stressors, syndemics, and their association with sexual risk outcomes among gay men.
abstract: Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questionnaires at baseline and 6-month follow-up. Syndemic variables included depression, polysubstance use, and intimate partner violence. Early life adversity variables measured retrospectively included physical and verbal bullying by peers and physical and sexual abuse by adults. A Cochran-Armitage trend test revealed a proportionate increase between number of syndemic problems and engagement in high-risk sex (p < .0001), thereby supporting syndemic theory. All early life adversity variables were positively correlated with number of syndemic problems. A bootstrap mediation analysis revealed indirect effects of two types of early life adversity on high-risk sex via syndemic severity: verbal bullying by peers and physical abuse by adults. There was also an overall effect of physical bullying by peers on high-risk sexual behavior, but no specific direct or indirect effects were observed. Consistent with syndemic theory, results provide evidence that certain types of early life adversity impact high-risk sex later in life via syndemic problems. Behavioral interventions to reduce sexual risk among GBM should address anti-gay discrimination experienced before adulthood as well as adult psychological problems.
authors.affiliation: Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
authors.forename: Tyler G
authors.initials: TG
authors.lastname: Tulloch
authors.forename: Nooshin K
authors.initials: NK
authors.lastname: Rotondi
authors.forename: Stanley
authors.initials: S
authors.lastname: Ing
authors.forename: Ted
authors.initials: T
authors.lastname: Myers
authors.forename: Liviana M
authors.initials: LM
authors.lastname: Calzavara
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Hart
mesh_terms: D000328:Adult; D058445:Bullying; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult