A Syndemic of Psychosocial Problems Places the MSM (Men Who Have Sex with Men) Population at Greater Risk of HIV Infection

Wu Jie,Lu Ciyong,Deng Xueqing,Wang Hui,Hong Lingyao,Vittoria Colizza

doi:10.1371/journal.pone.0032312

Abstract

BackgroundThe MSM (Men who have sex with men) population suffers from very high rates of concurrent psychosocial problems. Together, these problems comprise a syndemic that increases the risk of HIV infection for this community. The precise mechanisms through which this syndemic can raise the likelihood of HIV infection warrant further exploration.Methodology/Principal FindingsA total of 522 MSM were enrolled via a multiframe sampling approach and were asked to report psychosocial problems, risky sexual behaviors and HIV test results. A count of psychosocial health problems was calculated to test the additive relationship of these factors on HIV risk. Adjusting analysis and restriction analysis were used to determine a proposed intermediate pathway. Psychosocial health problems are highly concurrent and intercorrelated among urban MSM. Greater numbers of health problems are significantly and positively associated with HIV infection, which is mediated, at least partially, by risky sexual behaviors.Conclusions/SignificanceMSM experience concurrent psychosocial health problems that correlate with HIV infection in this community. We recommend the development of coping strategies for this population to deal with these psychosocial problems, both in prevention research and health policy.

Highlights

Men who have sex with men (MSM) have been disproportionately affected by the human immunodeficiency virus (HIV) and continue to be major drivers of the HIV/AIDS epidemic throughout the world
A total of 530 MSM were recruited for the study, and 522 (95.4%) completed the questionnaire and provided blood samples
Our study supports the previous evidence that additive psychosocial health problems—collectively known as a syndemic—exist among urban MSM

Summary

Introduction

Men who have sex with men (MSM) have been disproportionately affected by the human immunodeficiency virus (HIV) and continue to be major drivers of the HIV/AIDS epidemic throughout the world. Recent data indicate an emerging HIV epidemic among MSM in metropolitan areas of China [1,2,3,4]. MSM have recently emerged as a high-risk group in China. As alarming as these epidemiological data are, even more disturbing is the lack of preparedness to address HIV risk and prevention in this population. The MSM (Men who have sex with men) population suffers from very high rates of concurrent psychosocial problems. Together, these problems comprise a syndemic that increases the risk of HIV infection for this community. The precise mechanisms through which this syndemic can raise the likelihood of HIV infection warrant further exploration

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