title: Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City.
abstract: Syndemic theory has been proposed as a framework for understanding the role of multiple risk factors driving the HIV epidemic among sexual and gender minority individuals. As yet, the framework has been relatively absent in research on Latinos/as.
  
  
  
  We used logistic regression to assess relationships among cumulative syndemic conditions - including clinically significant depression, high-risk alcohol consumption, discrimination, and childhood sexual abuse - engagement with multiple partners and condomless anal intercourse (CAI) in a sample of 176 Latino men who have sex with men (MSM) in New York City.
  
  
  
  In bivariate analyses, an increase in the number of syndemic factors experienced was associated with an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participants with 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0 (aOR=4.66, 95% CI [1.29, 16.85); aOR=7.28, 95% CI [1.94, 27.28] and aOR=8.25, 95% CI [1.74, 39.24] respectively; p<0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0 aOR=7.35, 95% CI [1.64, 32.83] and OR=8.06, 95% CI [1.39, 46.73] respectively.
  
  
  
  Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.
authors.affiliation: School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA 19122, United States. Electronic address: omar.martinez@temple.edu.
authors.forename: Omar
authors.initials: O
authors.lastname: Martinez
authors.affiliation: Global Forum on MSM and HIV, 436 14th Street, Suite 100, Oakland, CA 94612, United States. Electronic address: sarreola@msmgf.org.
authors.forename: Sonya
authors.initials: S
authors.lastname: Arreola
authors.affiliation: School of Social Work at Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States. Electronic address: ew157@columbia.edu.
authors.forename: Elwin
authors.initials: E
authors.lastname: Wu
authors.affiliation: School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 551, Philadelphia, PA 19122, United States. Electronic address: miguel.munoz-laboy@temple.edu.
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Laboy
authors.affiliation: Department College of Liberal Arts, Temple University, Philadelphia, PA 19122, United States. Electronic address: elevine@temple.edu.
authors.forename: Ethan Czuy
authors.initials: EC
authors.lastname: Levine
authors.affiliation: College of Public Health, Temple University, 1101 W. Montgomery Ave. 3rd Floor, Philadelphia, PA 19122, United States. Electronic address: srutled@temple.edu.
authors.forename: Scott Edward
authors.initials: SE
authors.lastname: Rutledge
authors.affiliation: School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, Philadelphia, PA 19122, United States. Electronic address: tug29052@temple.edu.
authors.forename: Carolina
authors.initials: C
authors.lastname: Hausmann-Stabile
authors.affiliation: School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, United States. Electronic address: icard@temple.edu.
authors.forename: Larry
authors.initials: L
authors.lastname: Icard
authors.affiliation: Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, N.C. 27157, United States. Electronic address: srhodes@wakehealth.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Rhodes
authors.affiliation: HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, United States. Electronic address: ac72@cumc.columbia.edu.
authors.forename: Alex
authors.initials: A
authors.lastname: Carballo-Diéguez
authors.affiliation: University of Puerto Rico-Medical Sciences Campus, School of Public Health, PO Box 365067, San Juan, PR, 00936-5067, United States. Electronic address: carlos.rodriguez64@upr.edu.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rodríguez-Díaz
authors.affiliation: Behavioral Health Promotion Program, Nova Southeastern University, 2000 South Dixie Highway, Fort Lauderdale, FL, 33133, United States. Electronic address: mariafer@nova.edu.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fernandez
authors.affiliation: Clinical Sociomedical Sciences (in Psychiatry), Columbia University, 1051 Riverside Drive, Unit 15, NY, NY 10032, United States. Electronic address: tgs2001@columbia.edu.
authors.forename: Theo
authors.initials: T
authors.lastname: Sandfort
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D000437:Alcoholism / Q000208:ethnology / Q000523:psychology; D015897:Comorbidity; D017280:Condoms / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology* / Q000635:transmission*; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000208:ethnology* / Q000523:psychology*; D006801:Humans; D008297:Male; D009519:New York City; D011287:Prejudice / Q000208:ethnology / Q000523:psychology; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology; D047568:Unsafe Sex / Q000208:ethnology* / Q000523:psychology*; D055815:Young Adult
keywords: HIV risk behaviors; High-risk alcohol consumption; Latino men who have sex with men; Syndemic conditions