Social Determinants Of Health Framework Research Articles

Rethinking the Roles of the Social Determinants of Health in Bystander Intervention for Partner Violence Among College Students

Willingness to intervene as an effective bystander is critical in preventing partner violence and fostering safety among college students. Informed by the Social Determinants of Health framework, this conceptual paper provides an overview of the background and historical evolution of bystander intervention and invites a rethinking of how various factors impact bystander intervention for partner violence among college students by highlighting the roles of (1) economic factors and education, (2) sexual beliefs, myths, and media, (3) gender values and norms, (4) environmental factors, (5) college students at risk, (6) social support network and access to services, (7) acculturation and familiarity with the U.S. culture, and (8) cost-benefit analyses. We also discuss potential practice, research, and policy implications. Understanding the Social Determinants of Health is instrumental in addressing the root cause of intersecting health disparities, which is vital in preventing violence, encouraging bystander intervention, and creating a safer community.

2.P. Scientific session: Improving health impact assessment in the context of EU policy cycle

Abstract The European Commission (EC) is responsible for planning, preparing and proposing better and simpler new policies, avoiding unnecessary burdens, and involving citizens and any interested stakeholders in the decision-making process. The EC is also responsible for evaluating existing European laws and proposing improvements where necessary. In achieving these goals, the EC has defined its “Better regulation” (BR) policy, governed by a set of common principles and established procedures, including the assessment of the most significant impacts on the economic, environmental, and social domains, among others. These assessments should be based on the best available evidence, which refers to multiple sources of data, information and knowledge, including quantitative (e.g. statistics and measurements) and qualitative data (e.g. opinions, stakeholder input, scientific and expert advice). BR’s principles and procedures also ensure the implementation of more effective, coherent, relevant and efficient initiatives, improving the transparency, participation, learning and accountability. With this approach, the EC also seeks to guarantee that all legislative proposals contribute to the 2030 sustainable development agenda, and to better planetary health. As stated in the EU Treaty (Article 168 TFEU), “a high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities”. Therefore, assessment of any potential health impacts should be addressed during the policy cycle. Health gains and health losses can be direct or indirect, and particular attention should be given to specific population groups that may be disproportionally affected by the intervention (e.g., children, persons with disabilities, pregnant women, the elderly, low-income groups). The design and improvement of healthy public policies was precisely the ultimate goal for which the WHO proposed in 1999 the Health impact assessment (HIA) approach. HIA practice is grounded in the WHO’s health definition, which encompasses physical, mental and social health and well-being, and it is closely linked to the social determinants of health framework and to Health in All Policy strategy. Several quantitative methods are available to estimate health impacts within HIA applied to policies. The environmental burden of disease (EBD) is one of them aiming at quantifying the impact of a health problem as measured by avoidable mortality/morbidity, financial cost, or other indicators attributed to environmental factors (e.g. exposure to chemicals). EBD approach allows policy actions to be based on estimated health gains, rather than on “safe environmental levels” of the risk factor alone. The main aim of this session will be to analyses different quantitative approaches and provide some recommendations and good practice on how epidemiological evidence can support the policy cycle, improving data collection, evaluation and reporting suitable to such context. Key messages • Refining epidemiologic data recording and reporting, especially uncertainty characterisation, is necessary to improve weight-of-evidence evaluations for a better regulation process. • Environmental burden of disease, as a tool for quantifying health impacts, provides crucial information to policy makers on how to regulate for better protecting population health.

The loss of rural vital places: A case study using the social determinants of health framework

Healthy food sources, recreational facilities, and social spaces serve as vital places for supporting health. Less is known about what happens when vital places are lost, especially in rural contexts that have experienced disinvestment and population decline. In this paper we use a case study of a small rural community in Pennsylvania that lost a substantial share of its vital places over a short period of time to explore the experiences of local residents. Using qualitative interviews with 26 local residents we show that the loss of vital places, which are part of the neighborhood and built environment, intersected with other social determinants of health with potential consequences for health and well-being. This was often because vital places were essential (i.e., few or no alternatives existed) and multifunctional (i.e., supporting health through multiple behavioral and social mechanisms). Examining experiences of local residents following the loss of vital places through a social determinants of health lens helps to identify consequences and inform adaptation strategies. We also use the findings to refine the vital places framework for rural contexts.

The Use of the CDC Preventive Health and Health Services Block Grant to Address Social Determinants of Health to Advance Health Equity.

State public health departments use federal funding to examine and address social determinants of health (SDOH) within their communities to improve health and advance health equity. Yet, most federal funding is categorical (ie, funding used for a specific program or narrow purpose), which can create barriers to addressing social and structural drivers of inequity. The Preventive Health and Health Services Block Grant (PHHS Block Grant) is a flexible funding mechanism that provides health departments the latitude to identify and fund initiatives that address local public health needs. It is unclear, however, to what extent health departments use this flexible resource to incorporate SDOH into their programs. Cross-sectional, descriptive analysis of state health department PHHS Block Grant program administrative data. This study examined PHHS Block Grant budgets and workplans for the federal Fiscal Year 2021 to assess whether state health departments aligned their grant-funded program with the national objectives associated with the Healthy People 2030 SDOH Framework. Forty-seven states and the District of Columbia were included in this study. Percent of states that used PHHS Block Grant funds to address SDOH; proportion of funding allocated to address SDOH; percentage of programs that addressed SDOH. Three-fourths (75%) of states allocated funds to 97 programs aligning with at least 1 Healthy People 2030 SDOH-related objective. Fifty of the programs were fully or primarily funded by the PHHS Block Grant. Results also show that as the states' PHHS Block Grant funding level increased so did the percent of states that allocated funding toward SDOH programs. This study shows that state health departments are using the PHHS Block Grant to address SDOH, and that the grant plays an important funding role for these programs. States are incorporating the grant into their funding strategies to address SDOH.

A Shift in Approach to Addressing Public Health Inequities and the Effect of Societal Structural and Systemic Drivers on Social Determinants of Health.

Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that influence health outcomes, and structural and systemic drivers of health (SSD) are the social, cultural, political, and economic contexts that create and shape SDOH. With the integration of constructs from previous examples, we propose an SSD model that broadens the contextual effect of these driving forces or factors rooted in the Centers for Disease Control and Prevention's SDOH framework. Our SSD model (1) presents systems and structures as multidimensional, (2) considers 10 dimensions as discrete and intersectional, and (3) acknowledges health-related effects over time at different life stages and across generations. We also present an application of this SSD model to the housing domain and describe how SSD affect SDOH through multiple mechanisms that may lead to unequal resources, opportunities, and consequences contributing to a disproportionate burden of disease, illness, and death in the US population. Our enhanced SDOH framework offers an innovative and promising model for multidimensional, collaborative public health approaches toward achieving health equity and eliminating health disparities.

Re-politicizing the WHO's social determinants of health framework.

Although the World Health Organization's (WHO's) framework on social and structural determinants of health and health inequities (SSDHHI) has done much to raise awareness of these determinants, it does not go far enough in considerations of politics and power. The framework has become more de-politicized since its publication, with the definition of social determinants shifting toward downstream and individualized factors. In the meantime, new research fields on legal, commercial and political determinants of health and health inequities have emerged; however, these have not become integrated adequately into broader SSDHHI frameworks. To address these challenges, we argue for a re-politicization and an expansion of the WHO's framework by including the agents who have power over shaping structural determinants and the ways they use power to shape these determinants. We also provide a more detailed conceptualization of structural determinants to facilitate research. We propose a guideline for evaluating studies according to the extent to which they point upstream versus downstream and incorporate agents and considerations of power. We then use this framework to encourage more research on associations among agents, mechanisms of power, and structural determinants; how changes in structural determinants affect power dynamics among agents; and a wider focus on structural determinants beyond laws and policies, such as broad economic and sociopolitical systems. We also urge researchers to consider societal and institutional forces shaping their research with respect to SSDHHI. Research based on this framework can be used to provide evidence for advocacy for structural changes and to build more just systems that respect the fundamental human right to a healthy life.

Abstract A118: Barriers and facilitators to cervical cancer screening among older Hispanic women living in San Antonio, TX

Abstract Background: Disparities among Hispanic women getting screened for cervical cancer compared to non-Hispanic White women continue to exist, despite Hispanic women having higher incidence and mortality rates of cervical cancer. Previous work has shown limited knowledge and awareness about cervical cancer and screening, low health literacy, and cultural aspects such as fatalism as barriers to screening. On the other hand, having health insurance, a family history of cervical cancer and religiosity have been found to facilitate cervical cancer screening among Hispanic women. Moreover, in Texas, research has shown that women older than 50 and Hispanic women have lower rates of screening. Methods: Informed by the social determinants of health framework, we are interviewing Hispanic women living in San Antonio, TX about their experiences regarding cervical cancer screening. Questions cover the areas of knowledge about cervical cancer and cervical cancer screening, and barriers and facilitators to cervical cancer screening. We have completed 11 out of 36 planned interviews. Data analysis is guided by applied thematic analysis techniques. Preliminary Results: Currently, ages range from 50 to 64 years old. Most women are married and half are retired. Preliminary analysis shows continued low levels of knowledge about cervical cancer and screening. Barriers include feelings of fear and embarrassment about the test, physician’s gender, and access to healthcare, such as issues with transportation. Facilitators include physician’s attitude, clinic reminders, and having health insurance. Conclusion: More research is needed to understand and address barriers and facilitators to cervical cancer screening in this age group. Targeted public health efforts, including educational and multilevel interventions, should continue to increase knowledge about cervical cancer, and acceptability and access to cervical cancer screening among older Hispanic women living in San Antonio, TX. Citation Format: Coralia Vázquez-Otero, Audrey Cordova, Rita Pedraza, Selena Baglini, Amelie G. Ramírez. Barriers and facilitators to cervical cancer screening among older Hispanic women living in San Antonio, TX [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A118.

Bridging the gap: challenges and opportunities of assistive technology loan library systems for individuals with intellectual disabilities in the United States

Purpose In an increasingly technology-driven world, this study explores the accessibility of assistive technology for individuals with intellectual disabilities through assistive technology loan libraries. Assistive technology refers to devices or systems that enhance the ability of individuals with and without disabilities to function and undertake activities of daily living. Materials and methods The study, grounded in the Social Determinants of Health framework, employed multiple methods including both qualitative (interviews) and quantitative (questionnaire) methods, involving 19 participants comprising assistive technology professionals and users. Results Key findings from the study underscore the pivotal role of assistive technology loan libraries, which lend various assistive devices to individuals, enabling them to try these technologies before making a long-term commitment. However, challenges, such as a restricted variety of devices and extended waiting periods for access were highlighted. The research points to a need for improved training for both staff at the loan libraries and the users of the technology. It also suggests that policy enhancements are required to better align with rapid technological advancements and address the uneven regional distribution of these technologies. Conclusions Participants in the study highlighted the importance of expanding the range of assistive devices available in these libraries and improving the efficiency of the service they provide. The study advocates for targeted efforts to enhance the effectiveness and accessibility of assistive technology loan libraries, highlighting their critical role in empowering individuals with intellectual disabilities.

The Women and Children of India's Red-Light Brothel Districts: An Exploratory Investigation of Vulnerability and Survival During a Global Pandemic.

Globally, women and children were disproportionately impacted by the COVID-19 pandemic. Vulnerable populations of women and children-including those who live in poverty, lack access to health care, have little informal support, and who face stigma and discrimination-were particularly susceptible to harm incurred by the pandemic. Using social determinants of health framework, this investigation sought to understand the lived experiences of women and children residing in an impoverished, resource-poor, urban brothel red-light brothel area district in India, at the outset of the pandemic and following the national lockdown(s). Four questions guided the investigation: (1) How did participants first hear about COVID-19 and what was learned regarding self-protective measures? (2) What daily life challenges were posed by the national lockdown? (3) To what extent were participants able to access or rely on informal supports support during the initial stages of the pandemic? and (4) What types of assistance, if any, did participants receive from non-governmental organizations (NGOs) or other (e.g., governmental) sources? This is one of only a handful of empirical investigations elevating the voices of children residing in urban brothel-based red-light districts. Findings pose significant implications for practice, policy, and continued research.

Assessing the quality of life in a rural Thai province: A case study

This study investigates the impact of personal characteristics (PER), personal environment (PEV), individual factors (INF), and urban development (DEV) on the quality of life (QoL) in the northeastern (Isan) region of Thailand, specifically focusing on Roi Et Province. The research employs a quantitative approach using stratified random sampling to select a sample of 400 individuals from a population of just over 1 million residents. Data analysis was conducted using LISREL 9.1 for confirmatory factor analysis (CFA) and structural equation modeling (SEM) to explore the relationships between the variables. The results reveal significant positive relationships between the studied variables and their influence on public services. Personal characteristics showed a moderate positive effect on QoL, highlighting the importance of gender and community relationships. The personal environment significantly impacted QoL, emphasizing the role of supportive living conditions. Individual factors were crucial for QoL, indicating the significance of societal roles and personal well-being. Urban development directly influenced QoL, suggesting that well-planned infrastructure enhances residents' QoL. These findings align with the Social Determinants of Health framework and New Urbanism theory. This research underscores the multifaceted nature of QoL determinants in rural settings, demonstrating that both individual and environmental factors contribute to residents' well-being. The study provides valuable insights for policymakers and urban planners, suggesting that enhancing personal and environmental factors, alongside strategic urban development, can significantly improve the quality of life in rural areas.

Expanding ACES in child and family service systems: Incorporating context and resilience

The Adverse Childhood Experiences (ACEs) framework has been instrumental in illustrating the profound and long-term impact of early-life stressors in the developmental trajectories of children and families and well-being of our communities. However, despite its groundbreaking contributions, the ACEs framework predominately adopts a deficit-oriented lens, focusing on risk factors while often neglecting the protective and positive experiences children and families also experience. In the United States, communities that have been historically marginalized, including racial and ethnic minorities, are disproportionately impacted by ACEs due to systemic inequities and historical injustices, leading to persistent sociodemographic health and social disparities. Recent advances to the ACEs framework argue that the traditional ACEs model inadequately addresses the broader socio-structural, political, and economic contexts that influence adversity, including living in under-resourced communities, ongoing community violence and poor access to service systems. As a result, child, and family service systems (CFSS) may fail to consider how socio-structural factors, may potentially reinforce disparities in service access, delivery, and outcomes. This paper discusses the limitations of the traditional ACEs framework and advocates for a more comprehensive approach that incorporates socio-ecological and strengths-based perspectives like the Social Determinants of Health Framework and the Protective and Compensatory Experiences (PACEs) Framework. By shifting towards this holistic perspective, researchers and practitioners alike can better understand the interplay of systemic inequalities and socio-structural conditions in shaping ACEs exposure and outcomes, and, therefore, inform more effective practices, policies and services that can address both the immediate impact and root causes of adversity.

Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health.

Disparities exist in the identification, treatment, and management of delirium. These disparities can be most holistically and comprehensively understood by using a social-ecological model-which acknowledges multilevel impacts including individual, interpersonal, organizational, community, and policy-level factors-as well as a social determinant of health framework, that considers nonmedical factors that influence health outcomes. This narrative review leverages both frameworks to identify and discuss existing literature pertaining to the intersection of these social risk factors and delirium, focusing specifically on disparities due to racial and/or ethnic identity, language ability, and socioeconomic differences. We also look at disparities and the potential role of these social risk factors throughout the continuum of care, including prehospitalization, hospitalization, and posthospitalization factors. Understanding and analyzing the role of these inequities is critical to ensuring better health outcomes for patients at risk of and/or with delirium.

Racial/Ethnic Disparities in Cardiovascular Disease Outcomes: Using a Social Determinants of Health Framework to Identify Inequities in Healthcare Access and Treatment

Racial/Ethnic Disparities in Cardiovascular Disease Outcomes: Using a Social Determinants of Health Framework to Identify Inequities in Healthcare Access and Treatment

Structural Racism and Obesity-Related Cancer Inequities in the United States: Challenges and Research Priorities.

Structural racism has been identified as a fundamental cause of health disparities. For example, racial, ethnic, and economic neighborhood segregation; concentrated poverty; community disinvestment; and sociocultural context influence obesity and cancer disparities. Effects of structural racism are also evident through neighborhood obesogenic conditions such as limited access to affordable and healthy foods and physical activity opportunities within segregated communities that contribute to obesity and obesity-related cancer disparities. This article describes and expands on cross-cutting themes raised during a webinar held by the National Cancer Institute (NCI): (1) how structural factors, including neighborhood segregation and obesogenic conditions within racial and ethnic disadvantaged communities, influence disparities in the United States; (2) current research challenges and best ways to address them; and (3) selected priorities of the NCI aimed at addressing multilevel and intersecting factors that influence obesity-related cancer disparities. Further research is needed to understand how residential segregation and neighborhood obesogenic conditions influence cancer prevention and control across the continuum. Identifying the best approaches to address obesity and cancer disparities using social determinants of health framework and community-engaged approaches guided by a structural racism lens will allow researchers to move beyond individual-level approaches.

The Impact of Undermining Coparenting on the Mental and Physical Health Outcomes of Black Fathers: The Role of Depression and Restrictive Emotionality

ABSTRACT The parenting literature has established the coparenting relationship as central to the parenting behaviors and outcomes of men. The construct of coparenting encompasses supportive efforts among individuals that facilitate the rearing of children and unsupportive actions that can undermine parenting efforts (Merrifield & Gamble, 2013). Few studies have examined undermining coparenting as an experience that shapes Black men’s health outcomes. In this study, we apply the social determinants of health framework to examine the impact of Black fathers’ perceptions of undermining coparenting on their self-reported ratings of mental and physical health. Using a nationally representative sample of Black men (n = 255), correlational analyses revealed perceptions of undermining coparenting to be a significant predictor of higher levels of anger and poorer perceptions of physical health. These relationships were found to be mediated by depressive symptoms and moderated by restrictive emotionality. It is recommended that the negative impact of undermining coparenting on health be considered as a potential comorbidity contributing to negative health outcomes for Black men. This study adds to the literature on coparenting, Black men’s health, and Black fatherhood more generally and urges policymakers and practitioners to consider undermining as an often overlooked, but significant, social determinant of health impacting the well-being of Black men. We also offer recommendations for promoting Black men’s health by educating families on the effects of undermining and offering the supports necessary for achieving positive coparenting dynamics.

Food-based domestic violence and anemia among women in sexual unions in Nigeria: the effect of urbanization

In 2019, 1.74 billion people worldwide had anemia. In Nigeria, women of reproductive age are the most affected. Domestic violence affects the anemia prevalence, but few studies have examined the influence of urbanization on women in heterosexual unions (currently married, and cohabiting between). Using the social determinants of health framework, we argue that food-based violence and anemia vary among women residing in rural and urban areas. We used the Chi-square test and logistic regression to analyze the 2018 Nigeria Demographic and Health Survey records (n = 10,499). The study showed that anemia occurs more among women in rural (66%) than in urban (34%) areas. In rural areas, anemia was 29% higher among women who approved food-based domestic violence (OR: 1.29, CI 1.15–1.57) than those who did not. In urban areas, food-based domestic violence was not significantly associated with anemia. This study emphasizes the urgent need for culturally sensitive maternal health interventions aimed at re-orienting individuals and families on violence in rural areas.

The Role of Social Determinants in Diagnosis Timing for Fetal Care Center-Eligible Conditions: A Scoping Review.

Timely identification of fetal conditions enables comprehensive evaluation, counseling, postnatal planning, and prenatal treatments. This study assessed the existing evidence on how social determinants of health (SDOH) influence diagnosis timing of fetal conditions appropriate for care in fetal care centers (FCCs). Eligible studies were conducted in the U.S. and published in English after 1999. We employed the Healthy People 2020 SDOH framework to categorize and analyze data from 16 studies, where 86% focused solely on congenital heart disease (CHD). Studies primarily focused on individual-level SDOH, with only 36% addressing structural-level factors. A total of 31 distinct indicators of SDOH were identified, with 68% being unique to individual studies. Indicators often varied in definition and specificity. Three studies covered all five SDOH categories in the Healthy People 2020 Framework. Studies revealed varying and often conflicting associations with SDOH indicators, with race and ethnicity being the most explored (100%), followed by socioeconomic status (69%), maternal age (57%), residence (43%), and structural factors (29%). Our findings highlight the need for more comprehensive research, including conditions beyond CHD, and the establishment of consensus on indicators of SDOH. Such efforts are necessary to gain a deeper understanding of the underlying factors driving disparities in fetal diagnosis and treatment.

Cognitive Impairment and Social Determinants of Health Among Indigenous Women.

Cognitive impairment and Alzheimer's disease and related dementias (ADRD) pose significant challenges for Indigenous populations, necessitating urgent research. Limited evidence suggests that high rates of ADRD among Indigenous peoples are associated with social determinants of health (SDOH), such as education, income, health literacy, religion, and social engagement. Collaborating with a Northern Plains tribe, participants were recruited 123 self-identified Indigenous women aged 40-70 through a comprehensive recruitment strategy. Employing the SDOH framework, the research assessed cognitive impairment and Alzheimer's disease knowledge (ADK), utilizing the Ascertain Dementia 8 and Alzheimer's disease knowledge scales (ADK-30). The investigation examined the relationships between selected SDOH variables and cognitive impairment status. More than half of the participants showed signs of cognitive impairment, which correlated with lower income and education levels. Increased knowledge about Alzheimer's disease, particularly in terms of treatment management and its life impact subscales, was associated with lower odds of cognitive impairment. Conversely, higher levels of depressive symptoms and participation in religious activities were linked to increased odds of cognitive impairment. The findings underscore the importance of culturally grounded tools and SDOH frameworks tailored to Indigenous contexts in addressing ADRD disparities. Future research should integrate historical and cultural factors to advance health equity within Indigenous communities, ultimately mitigating the impact of ADRD and promoting overall well-being.

Sport, neurodegenerative illness and the social determinants of health

ABSTRACT This article proposes a Social Determinants of Health framework as a counter to the prominence of bio-determinist tropes in understandings of the relationship between concussion and later life neurodegenerative conditions in athletic populations. It is argued that debates about concussion (or repetitive head impacts) causing CTE have been particularly influenced by broader social trends towards neuro-essentialism. This paradigm reduces complex social behaviour to brain matter and continues to dominate the field despite the recent diversification of evidence from autopsy-based studies of neuropathology to epidemiological studies comparing recorded causes of death among former elite athletes. In contrast, this article explores the ‘causes of causes’ of neurodegenerative conditions. It outlines the ways in which the distinct dynamics of: a) employment, b) education, income and wealth, c) health systems and services, and d) social environment and public safety relate to the specific occupational conditions of elite sport and likely negatively shape health outcomes of athletic populations. The article concludes by arguing that to more effectively address these particular health harms we must move beyond narrow, mono-causal models and evoke a cultural change that extends beyond making rule changes and adjusting psychological attitudes and behavioural norms, to redress the social structural parameters of elite sports participation. The continuation of narrower, neuro-centric and reductionist paradigms obscures the causes of the causes of neurodegenerative decline and limits the scope for change.

Understanding the influence of Social Determinants of Health (SDH) on suicidal behaviors among HIV-positive men who have sex with men (MSM) in China: A population-based study

BackgroundHIV-positive men who have sex with men (MSM) are at high risk of suicide and experience intersectional inequalities. The Social Determinants of Health (SDH) framework provides valuable insights into how inequalities can lead to adverse outcomes. This study aimed to employ the SDH framework to identify factors that contribute to suicidal behaviors among this population. Methods1410 HIV-positive MSM were recruited using a web-based questionnaire, whose mean age was 30.77 ± 6.92 years old. Participants completed questionnaires including baseline information and psychological measurements, such as Suicidal Behaviors Questionnaire-Revised (SBQ-R). Logistic regression analysis was conducted to screen for risk factors associated with suicidal behaviors. ResultsMore than half of the participants (53.3 %, 752/1410) had an SBQ score of 7 or higher. Binary logistic regression analysis of structural and intermediary determinants (Model 3) revealed that sexual orientation, stigma (ORs: 1.018, 95 % CI: 1.005–1.032), interpersonal needs (ORs: 1.021, 95 % CI: 1.010–1.031), depression (ORs: 1.037, 95 % CI: 1.001–1.074) and entrapment (ORs: 1.018, 95 % CI: 1.004–1.032) were positively correlated with suicidal behaviors. Individuals with other or unknown sexual orientation had significantly higher rates of suicidal behaviors compared to those with a heterosexual sexual orientation (ORs: 5.021, 95 % CI: 1.529–17.640). LimitationsSampling of HIV-positive MSM posed challenges in data collection. It may introduce selection bias and affect generalizability. ConclusionThis study identified that sexual orientation, stigma, interpersonal needs, depression, and entrapment were significantly associated with suicidal behaviors among HIV-positive MSM. Additionally, these factors can be social determinants of health that contribute to suicidal behaviors.