title: Prospective Effects of a Syndemic on HIV and STI Incidence and Risk Behaviors in a Cohort of Young Men Who Have Sex with Men.
abstract: Young men who have sex with men continue to be highly affected by HIV. To improve understanding of the role that multiple co-occurring health issues (i.e., syndemics) play in HIV acquisition, sophisticated modeling methods are needed. The purpose of this study was to use structural equation modeling to understand the structure of the syndemic and to test its longitudinal association with condomless anal sex. Data are from a longitudinal study of 450 YMSM. A primary syndemic component comprised of substance use, violence, and internalizing mental health factors significantly predicted the number of condomless anal sex partners in the full sample. Analyses exploring associations by race/ethnicity found a significant association among White YMSM, but not among Black or Latino YMSM. Higher-order factor modeling suggests these psychosocial factors form a syndemic in all racial/ethnic groups, but the syndemic, as conceptualized here, may be less relevant to racial/ethnic minority YMSM.
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. brian@northwestern.edu.|Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 2700, Chicago, IL, 60611, USA. brian@northwestern.edu.
authors.forename: Brian
authors.identifier: http://orcid.org/0000-0001-9222-5116
authors.initials: B
authors.lastname: Mustanski
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 2700, Chicago, IL, 60611, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Phillips
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 2700, Chicago, IL, 60611, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Ryan
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 2700, Chicago, IL, 60611, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Swann
authors.affiliation: Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kuhns
authors.affiliation: Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Rob
authors.initials: R
authors.lastname: Garofalo
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D011446:Prospective Studies; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014754:Violence; D055815:Young Adult
keywords: Factor analysis; HIV; Syndemic; YMSM