Omar Martinez1, Sonya Arreola2, Elwin Wu3, Miguel Muñoz-Laboy4, Ethan Czuy Levine5, Scott Edward Rutledge6, Carolina Hausmann-Stabile7, Larry Icard8, Scott D Rhodes9, Alex Carballo-Diéguez10, Carlos E Rodríguez-Díaz11, M Isabel Fernandez12, Theo Sandfort13. 1. 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. 2. Global Forum on MSM and HIV, 436 14th Street, Suite 100, Oakland, CA 94612, United States. Electronic address: sarreola@msmgf.org. 3. School of Social Work at Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States. Electronic address: ew157@columbia.edu. 4. 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. 5. Department College of Liberal Arts, Temple University, Philadelphia, PA 19122, United States. Electronic address: elevine@temple.edu. 6. College of Public Health, Temple University, 1101 W. Montgomery Ave. 3rd Floor, Philadelphia, PA 19122, United States. Electronic address: srutled@temple.edu. 7. 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. 8. School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, United States. Electronic address: icard@temple.edu. 9. Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, N.C. 27157, United States. Electronic address: srhodes@wakehealth.edu. 10. 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. 11. 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. 12. Behavioral Health Promotion Program, Nova Southeastern University, 2000 South Dixie Highway, Fort Lauderdale, FL, 33133, United States. Electronic address: mariafer@nova.edu. 13. Clinical Sociomedical Sciences (in Psychiatry), Columbia University, 1051 Riverside Drive, Unit 15, NY, NY 10032, United States. Electronic address: tgs2001@columbia.edu.
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.
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