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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

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  • Chakrapani, Venkatesan
  • Kaur, Manmeet
  • Tsai, Alexander C.
  • Newman, Peter A.
  • Kumar, Rajesh

Abstract

This study aimed to examine the effect of a syndemic theory-based intervention to reduce condomless anal intercourse among men who have sex with men (MSM) in India. In 2016/17, a pre- and post-test comparison group design was used to implement a syndemic theory-based intervention among 459 MSM (229, intervention; 230, standard-of-care comparison) recruited through non-governmental organizations in Chandigarh, India. The intervention group received two-session peer-delivered motivational interviewing-based HIV risk reduction counselling and skills training to improve sexual communication/negotiation and condom use self-efficacy, and screening/management of psychosocial health problems. The intervention's effect on consistent condom use was estimated using difference-in-differences (DiD) approach. Mediation analysis assessed the extent to which intervention effects on the outcome were mediated by changes in psychosocial health problems and condom use self-efficacy. A process evaluation assessed implementation fidelity and intervention acceptability. Baseline consistent condom use was 43% in the intervention group and 46% in the standard-of-care group. Baseline survey findings demonstrated that a psychosocial syndemic of problematic alcohol use, internalised homonegativity and violence victimisation synergistically increased condomless anal intercourse. Using DiD, we estimated that the intervention increased consistent condom use with male partners by 16.4% (95% CI: 7.1, 25.7) and with female partners by 28.2% (95% CI: 11.9, 44.4), and decreased problematic alcohol use by 24.3% (95%CI: −33.4, −15.3), depression by 20.0% (95% CI: −27.6, −12.3) and internalised homonegativity by 34.7% (95% CI: −43.6%, −25.8%). The mediation analysis findings suggested that the intervention might have improved consistent condom use by decreasing internalised homonegativity and by increasing condom use self-efficacy. The process evaluation showed high levels of acceptability/satisfaction among participants and high levels of implementation fidelity. A syndemic theory-based intervention tailored for MSM in India is feasible, acceptable, and can reduce HIV transmission risk behaviour as well as problematic alcohol use, depression and internalised homonegativity.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:socmed:v:295:y:2022:i:c:s0277953620300368
    DOI: 10.1016/j.socscimed.2020.112817
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    References listed on IDEAS

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    1. Logie, Carmen H. & Newman, Peter A. & Chakrapani, Venkatesan & Shunmugam, Murali, 2012. "Adapting the minority stress model: Associations between gender non-conformity stigma, HIV-related stigma and depression among men who have sex with men in South India," Social Science & Medicine, Elsevier, vol. 74(8), pages 1261-1268.
    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. Pitpitan, E.V. & Strathdee, S.A. & Semple, S.J. & Chavarin, C.V. & Magis-Rodriguez, C. & Patterson, T.L., 2015. "Buffering syndemic effects in a sexual risk-reduction intervention for male clients of female sex workers: Results from a randomized controlled trial," American Journal of Public Health, American Public Health Association, vol. 105(9), pages 1866-1871.
    5. Garofalo, R. & Herrick, A. & Mustanski, B.S. & Donenberg, G.R., 2007. "Tip of the iceberg: Young men who have sex with men, the internet, and HIV risk," American Journal of Public Health, American Public Health Association, vol. 97(6), pages 1113-1117.
    6. Shaodong Ye & Lu Yin & Rivet Amico & Jane Simoni & Sten Vermund & Yuhua Ruan & Yiming Shao & Han-Zhu Qian, 2014. "Efficacy of Peer-Led Interventions to Reduce Unprotected Anal Intercourse among Men Who Have Sex with Men: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-11, March.
    7. 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.
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