caa a22 4500 606231188 CHVBK 20210128101218.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10508-015-0488-2 doi (NATIONALLICENCE)springer-10.1007/s10508-015-0488-2 High Prevalence of Multiple Syndemic Conditions Associated with Sexual Risk Behavior and HIV Infection Among a Large Sample of Spanish- and Portuguese-Speaking Men Who Have Sex with Men in Latin America [Elektronische Daten] [Matthew Mimiaga, Katie Biello, Angela Robertson, Catherine Oldenburg, Joshua Rosenberger, Conall O'Cleirigh, David Novak, Kenneth Mayer, Steven Safren] The HIV epidemic in Latin America is highly concentrated in men who have sex with men (MSM). In the United States, multiple co-occurring psychosocial conditions have been shown to act as intertwined epidemics to potentiate HIV transmission among MSM. To date, no study has examined the role of syndemics and condomless sex among MSM in Latin America. In 2012, an online survey was conducted among members of the largest social/sexual networking website for MSM in Latin America. Participants were asked about demographics, sexual behaviors, HIV/STI diagnoses, and psychosocial well-being, including depression, suicidal ideation, hazardous alcohol use, hard drug use during sex, history of childhood/adolescent sexual abuse, intimate partner violence, and sexual compulsivity. Multivariable logistic generalized estimation equations were used to assess the relationship of syndemic factors and (1) engagement in higher risk condomless anal sex and (2) self-report of prior HIV diagnosis. Among 24,274 survey respondents, 74.6% of the sample had at least one syndemic factor. In an additive model, syndemics were associated with increased odds of higher risk condomless anal sex, ranging from adjusted odds ratio of 1.31 (95% CI 1.20, 1.43) for one syndemic factor to 4.06 (95% CI 3.25, 5.09) for 6/7 syndemic factors. Similarly, syndemics were associated with increased odds of HIV infection (p<.0001). This study provides initial evidence that intertwined syndemics increase HIV risk behavior and HIV infection among MSM in Latin America. In the Latin American context, comprehensive HIV prevention interventions for MSM should be developed and tested that simultaneously address co-occurring psychosocial conditions and HIV risk. Springer Science+Business Media New York, 2015 HIV nationallicence Men who have sex with men nationallicence Sexual behavior nationallicence Syndemics nationallicence Latin America nationallicence Internet nationallicence Sexual orientation nationallicence Mimiaga Matthew Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut Biello Katie Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut Robertson Angela Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut Oldenburg Catherine Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut Rosenberger Joshua Department of Global and Community Health, George Mason University, Fairfax, VA, USA aut O'Cleirigh Conall Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut Novak David OLB Research Institute, Online Buddies, Inc., Cambridge, MA, USA aut Mayer Kenneth The Fenway Institute, Fenway Health, Boston, MA, USA aut Safren Steven Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut Archives of Sexual Behavior Springer US; http://www.springer-ny.com 44/7(2015-10-01), 1869-1878 0004-0002 44:7<1869 2015 44 10508 https://doi.org/10.1007/s10508-015-0488-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10508-015-0488-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mimiaga Matthew Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Biello Katie Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut NATIONALLICENCE 700 1- Robertson Angela Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut NATIONALLICENCE 700 1- Oldenburg Catherine Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA aut NATIONALLICENCE 700 1- Rosenberger Joshua Department of Global and Community Health, George Mason University, Fairfax, VA, USA aut NATIONALLICENCE 700 1- O'Cleirigh Conall Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Novak David OLB Research Institute, Online Buddies, Inc., Cambridge, MA, USA aut NATIONALLICENCE 700 1- Mayer Kenneth The Fenway Institute, Fenway Health, Boston, MA, USA aut NATIONALLICENCE 700 1- Safren Steven Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, 02114, Boston, MA, USA aut NATIONALLICENCE 773 0- Archives of Sexual Behavior Springer US; http://www.springer-ny.com 44/7(2015-10-01), 1869-1878 0004-0002 44:7<1869 2015 44 10508