IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v206y2018icp110-116.html
   My bibliography  Save this article

Is there synergy in syndemics? Psychosocial conditions and sexual risk among men who have sex with men in India

Author

Listed:
  • Tomori, Cecilia
  • McFall, Allison M.
  • Solomon, Sunil S.
  • Srikrishnan, Aylur K.
  • Anand, Santhanam
  • Balakrishnan, P.
  • Mehta, Shruti H.
  • Celentano, David D.

Abstract

Syndemic theory describes the clustering and synergistic interaction of disease driven by contextual and social factors, which worsen health outcomes for a population, and has been applied to men who have sex with men (MSM) and their risk for HIV and other sexually transmitted infections. Recent reviews, however, have critiqued prevailing approaches in syndemic studies that assess only additive associations without evaluation of synergy. Following these suggestions, we compared the traditional additive approach with a test for synergistic association of 5 syndemic conditions (alcohol dependence, illicit drug use, depression, intimate partner violence (IPV), and childhood sexual abuse (CSA)) with unprotected anal intercourse (UAI) and active syphilis infection among 11,771 MSM recruited through respondent driven sampling from 12 cities in India. UAI was assessed via self-report and active syphilis infection was diagnosed by RPR and THPA tests. An additive association was explored using a condition count (range 0–5), and synergy was tested using relative excess risk due to interactions (RERIs) calculated from all 2-way and common 3-way interactions between conditions in adjusted regression models. There was a significant dose response associated with the syndemic count and UAI, and a similar pattern for syphilis, though not statistically significant. RERIs showed synergy for only one pair of conditions for UAI and syphilis, respectively: IPV + depression and alcohol dependence + illicit drug use. In this study, we found an additive association between syndemic conditions and UAI with evidence of synergistic interaction between a pair of psychosocial conditions, and no significant additive association, but a synergistic interaction between another pair of psychosocial conditions for syphilis. Our results lend further support to a critical reassessment of syndemic analyses. Closer attention to the cumulative development, underlying causal pathways, and possible synergistic interaction of co-occurring epidemics through combined qualitative and quantitative methodologies may yield more effective interventions for vulnerable, marginalized populations.

Suggested Citation

  • Tomori, Cecilia & McFall, Allison M. & Solomon, Sunil S. & Srikrishnan, Aylur K. & Anand, Santhanam & Balakrishnan, P. & Mehta, Shruti H. & Celentano, David D., 2018. "Is there synergy in syndemics? Psychosocial conditions and sexual risk among men who have sex with men in India," Social Science & Medicine, Elsevier, vol. 206(C), pages 110-116.
    • Handle: RePEc:eee:socmed:v:206:y:2018:i:c:p:110-116
    DOI: 10.1016/j.socscimed.2018.03.032
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953618301503
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2018.03.032?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Maninder Setia & Murugesan Sivasubramanian & Vivek Anand & Ashok Row-Kavi & Hemangi Jerajani, 2010. "Married men who have sex with men: the bridge to HIV prevention in Mumbai, India," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(6), pages 687-691, December.
    2. Tsai, Alexander C. & Burns, Bridget F.O., 2015. "Syndemics of psychosocial problems and HIV risk: A systematic review of empirical tests of the disease interaction concept," Social Science & Medicine, Elsevier, vol. 139(C), pages 26-35.
    3. Stall, R. & Mills, T.C. & Williamson, J. & Hart, T. & Greenwood, G. & Paul, J. & Pollack, L. & Binson, D. & Osmond, D. & Catania, J.A., 2003. "Association of Co-Occurring Psychosocial Health Problems and Increased Vulnerability to HIV/AIDS among Urban Men Who Have Sex with Men," American Journal of Public Health, American Public Health Association, vol. 93(6), pages 939-942.
    4. AfDB AfDB, . "Annual Report 2012," Annual Report, African Development Bank, number 461.
    5. WorldFish, 2013. "Annual report 2012/13," Monographs, The WorldFish Center, number 40306, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Danni Xia & Yingjie Chen & Ruijie Chang & Chen Xu & Xiaoyue Yu & Yujie Liu & Hui Chen & Rongxi Wang & Shangbin Liu & Xin Ge & Yuxuan Wang & Ajuan Liang & Fan Hu & Yong Cai & Ying Wang, 2022. "Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework," IJERPH, MDPI, vol. 19(23), pages 1-14, December.
    2. Hatcher, Abigail M. & Gibbs, Andrew & McBride, Ruari-Santiago & Rebombo, Dumisani & Khumalo, Mzwakhe & Christofides, Nicola J., 2022. "Gendered syndemic of intimate partner violence, alcohol misuse, and HIV risk among peri-urban, heterosexual men in South Africa," Social Science & Medicine, Elsevier, vol. 295(C).
    3. Ouafik, Maxence R. & Buret, Laetitia & Scholtes, Beatrice, 2022. "Mapping the current knowledge in syndemic research applied to men who have sex with men: A scoping review," Social Science & Medicine, Elsevier, vol. 306(C).
    4. Chakrapani, Venkatesan & Kaur, Manmeet & Tsai, Alexander C. & Newman, Peter A. & Kumar, Rajesh, 2022. "The impact of a syndemic theory-based intervention on HIV transmission risk behaviour among men who have sex with men in India: Pretest-posttest non-equivalent comparison group trial," Social Science & Medicine, Elsevier, vol. 295(C).
    5. Brewis, Alexandra & Wutich, Amber & Galvin, Michael & Lachaud, James, 2022. "Localizing syndemics: A comparative study of hunger, stigma, suffering, and crime exposure in three Haitian communities," Social Science & Medicine, Elsevier, vol. 295(C).
    6. Snodgrass, Jeffrey G. & Lacy, Michael G. & Cole, Steven W., 2022. "Internet gaming, embodied distress, and psychosocial well-being: A syndemic-syndaimonic continuum," Social Science & Medicine, Elsevier, vol. 295(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tarek Roshdy Gebba & Mohamed Gamal Aboelmaged, 2016. "Corporate Governance of UAE Financial Institutions: A Comparative Study between Conventional and Islamic Banks," Journal of Applied Finance & Banking, SCIENPRESS Ltd, vol. 6(5), pages 1-7.
    2. Tyce, Matthew, 2020. "Beyond the neoliberal-statist divide on the drivers of innovation: A political settlements reading of Kenya’s M-Pesa success story," World Development, Elsevier, vol. 125(C).
    3. Flood, Mark D. & Lemieux, Victoria L. & Varga, Margaret & William Wong, B.L., 2016. "The application of visual analytics to financial stability monitoring," Journal of Financial Stability, Elsevier, vol. 27(C), pages 180-197.
    4. Molyneaux, Lynette & Wagner, Liam & Foster, John, 2016. "Rural electrification in India: Galilee Basin coal versus decentralised renewable energy micro grids," Renewable Energy, Elsevier, vol. 89(C), pages 422-436.
    5. repec:zbw:bofrdp:urn:nbn:fi:bof-201511261452 is not listed on IDEAS
    6. World Bank Group, 2015. "FYR Macedonia Public Expenditure Review," World Bank Publications - Reports 23808, The World Bank Group.
    7. Mahanta, Ratul & Chowdhury, Jayashree & Nath, Hiranya K., 2016. "Health costs of arsenic contamination of drinking water in Assam, India," Economic Analysis and Policy, Elsevier, vol. 49(C), pages 30-42.
    8. García-Posada, Miguel & Marchetti, Marcos, 2016. "The bank lending channel of unconventional monetary policy: The impact of the VLTROs on credit supply in Spain," Economic Modelling, Elsevier, vol. 58(C), pages 427-441.
    9. Collins, Ross D. & Selin, Noelle E. & de Weck, Olivier L. & Clark, William C., 2017. "Using inclusive wealth for policy evaluation: Application to electricity infrastructure planning in oil-exporting countries," Ecological Economics, Elsevier, vol. 133(C), pages 23-34.
    10. Yang, Daojian & Qi, Ershi & Li, Yajiao, 2015. "Quick response and supply chain structure with strategic consumers," Omega, Elsevier, vol. 52(C), pages 1-14.
    11. Garrett Ward Richards, 2019. "The Science–Policy Relationship Hierarchy (SPRHi) model of co-production: how climate science organizations have influenced the policy process in Canadian case studies," Policy Sciences, Springer;Society of Policy Sciences, vol. 52(1), pages 67-95, March.
    12. Bird, Lori & Lew, Debra & Milligan, Michael & Carlini, E. Maria & Estanqueiro, Ana & Flynn, Damian & Gomez-Lazaro, Emilio & Holttinen, Hannele & Menemenlis, Nickie & Orths, Antje & Eriksen, Peter Børr, 2016. "Wind and solar energy curtailment: A review of international experience," Renewable and Sustainable Energy Reviews, Elsevier, vol. 65(C), pages 577-586.
    13. Yao, Richard T. & Scarpa, Riccardo & Harrison, Duncan R. & Burns, Rhys J., 2019. "Does the economic benefit of biodiversity enhancement exceed the cost of conservation in planted forests?," Ecosystem Services, Elsevier, vol. 38(C), pages 1-1.
    14. Saari, M. Yusof & Rahman, M. Affan Abdul & Hassan, Azman & Habibullah, Muzafar Shah, 2016. "Estimating the impact of minimum wages on poverty across ethnic groups in Malaysia," Economic Modelling, Elsevier, vol. 54(C), pages 490-502.
    15. Ouafik, Maxence R. & Buret, Laetitia & Scholtes, Beatrice, 2022. "Mapping the current knowledge in syndemic research applied to men who have sex with men: A scoping review," Social Science & Medicine, Elsevier, vol. 306(C).
    16. Berghöfer, Britta & Lucey, Brian, 2014. "Fuel hedging, operational hedging and risk exposure — Evidence from the global airline industry," International Review of Financial Analysis, Elsevier, vol. 34(C), pages 124-139.
    17. David Talbot & Olivier Boiral, 2018. "GHG Reporting and Impression Management: An Assessment of Sustainability Reports from the Energy Sector," Journal of Business Ethics, Springer, vol. 147(2), pages 367-383, January.
    18. Marshall, Jonathan Paul, 2016. "Disordering fantasies of coal and technology: Carbon capture and storage in Australia," Energy Policy, Elsevier, vol. 99(C), pages 288-298.
    19. Aashish Argade & Sukhpal Singh, 2016. "Seeking Markets in Production Fields: An Assessment of the Potential for Fair Trade in India," Millennial Asia, , vol. 7(2), pages 131-152, October.
    20. Haerer, Drew & Pratson, Lincoln, 2015. "Employment trends in the U.S. Electricity Sector, 2008–2012," Energy Policy, Elsevier, vol. 82(C), pages 85-98.
    21. O'Kelly, Morton E., 2014. "Air freight hubs in the FedEx system: Analysis of fuel use," Journal of Air Transport Management, Elsevier, vol. 36(C), pages 1-12.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:206:y:2018:i:c:p:110-116. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.