IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i6p1924-d332921.html
   My bibliography  Save this article

Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV

Author

Listed:
  • Randolph C. H. Chan

    (Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong 999077, China)

  • Don Operario

    (Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI 02912, USA)

  • Winnie W. S. Mak

    (Department of Psychology, The Chinese University of Hong Kong, Hong Kong 999077, China)

Abstract

In the context of HIV-related stigma and discrimination, people living with HIV (PLHIV) might be vulnerable to a ‘syndemic’ of co-occurring psychosocial challenges that can affect sexual behavior. The present study examined how HIV-related discrimination contributes to co-occurring psychosocial syndemic problems and results in inconsistent condom use among PLHIV in Hong Kong. Two-hundred and ninety-one PLHIV were recruited to complete a self-report questionnaire. More than one-quarter of the sample experienced two or more psychosocial syndemic problems, and 74.1% of the participants who had sex with steady partners reported inconsistent condom use over the past three months. The results indicated that HIV-related discrimination was positively predictive of the number of psychosocial syndemic problems. HIV-related discrimination and psychosocial syndemics were associated with increased odds of inconsistent condom use with steady partners (AOR = 5.40 and AOR = 3.09 respectively). Findings from structural equation modeling showed that psychosocial syndemics mediated the effect of HIV-related discrimination on condom use consistency with steady partners. PLHIV in Hong Kong suffered from the syndemic effects of stigma, social isolation, and poor mental health, which rendered them vulnerable to condomless sex. In order to curb the rapidly increasing incidence of HIV, multi-level strategies should be adopted to concurrently address the structural inequities and psychosocial syndemics faced by PLHIV.

Suggested Citation

  • Randolph C. H. Chan & Don Operario & Winnie W. S. Mak, 2020. "Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV," IJERPH, MDPI, vol. 17(6), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:6:p:1924-:d:332921
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/6/1924/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/6/1924/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. Hyunjean Kim & Yingxin He & Ryan Pham & Gira J. Ravelo & Patria Rojas & Pura Rodriguez & Grettel Castro & Noël C. Barengo & Juan M. Acuña & Elena Cyrus, 2019. "Analyzing the Association Between Depression and High-Risk Sexual Behavior Among Adult Latina Immigrant Farm Workers in Miami-Dade County," IJERPH, MDPI, vol. 16(7), pages 1-10, March.
    3. Mustanski, B. & Andrews, R. & Herrick, A. & Stall, R. & Schnarrs, P.W., 2014. "A Syndemic of Psychosocial Health Disparities and Associations With Rifor Attempting Suicide Among Young Sexual Minority Men," American Journal of Public Health, American Public Health Association, vol. 104(2), pages 287-294.
    4. Patria Rojas & Hui Huang & Tan Li & Gira J. Ravelo & Mariana Sanchez & Christyl Dawson & Judith Brook & Mariano Kanamori & Mario De La Rosa, 2016. "Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample," IJERPH, MDPI, vol. 13(11), pages 1-21, November.
    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. Mak, Winnie W.S. & Cheung, Rebecca Y.M. & Law, Rita W. & Woo, Jean & Li, Patrick C.K. & Chung, Rita W.Y., 2007. "Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS," Social Science & Medicine, Elsevier, vol. 64(8), pages 1549-1559, April.
    7. Mak, Winnie W.S. & Mo, Phoenix K.H. & Cheung, Rebecca Y.M. & Woo, Jean & Cheung, Fanny M. & Lee, Dominic, 2006. "Comparative stigma of HIV/AIDS, SARS, and Tuberculosis in Hong Kong," Social Science & Medicine, Elsevier, vol. 63(7), pages 1912-1922, October.
    8. Singer, Merrill, 1994. "Aids and the health crisis of the U.S. urban poor; the perspective of critical medical anthropology," Social Science & Medicine, Elsevier, vol. 39(7), pages 931-948, October.
    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. Tyler D. Harvey & Ijeoma Opara & Emily A. Wang, 2022. "Role of the Intersections of Gender, Race and Sexual Orientation in the Association between Substance Use Behaviors and Sexually Transmitted Infections in a National Sample of Adults with Recent Crimi," IJERPH, MDPI, vol. 19(7), pages 1-14, March.
    2. Young-Jae Kim & Jeong-hyung Cho & Seung-Woo Kang, 2020. "Study on the Relationship between Leisure Activity Participation and Wearing a Mask among Koreans during COVID-19 Crisis: Using TPB Model," IJERPH, MDPI, vol. 17(20), pages 1-10, October.
    3. Emmanuel Peprah & Elisabet Caler & Anya Snyder & Fassil Ketema, 2020. "Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV," IJERPH, MDPI, vol. 17(13), pages 1-7, June.

    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. Yang, Lawrence Hsin & Kleinman, Arthur, 2008. "'Face' and the embodiment of stigma in China: The cases of schizophrenia and AIDS," Social Science & Medicine, Elsevier, vol. 67(3), pages 398-408, August.
    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. 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. Tsai, Alexander C. & Tomlinson, Mark & Comulada, W. Scott & Rotheram-Borus, Mary Jane, 2016. "Food insufficiency, depression, and the modifying role of social support: Evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa," Social Science & Medicine, Elsevier, vol. 151(C), pages 69-77.
    6. Saxena, Akshar & Mendenhall, Emily, 2022. "Syndemic thinking in large-scale studies: Case studies of disability, hypertension, and diabetes across income groups in India and China," Social Science & Medicine, Elsevier, vol. 295(C).
    7. 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).
    8. Boateng, Godfred O. & Workman, Cassandra L. & Miller, Joshua D. & Onono, Maricianah & Neilands, Torsten B. & Young, Sera L., 2022. "The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women," Social Science & Medicine, Elsevier, vol. 295(C).
    9. 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).
    10. Daftary, Amrita, 2012. "HIV and tuberculosis: The construction and management of double stigma," Social Science & Medicine, Elsevier, vol. 74(10), pages 1512-1519.
    11. Harvey, Tyler D. & Keene, Danya E. & Pachankis, John E., 2021. "Minority stress, psychosocial health, and survival among gay and bisexual men before, during, and after incarceration," Social Science & Medicine, Elsevier, vol. 272(C).
    12. Lisa Hightow-Weidman & Sara LeGrand & Seul Ki Choi & Joseph Egger & Christopher B Hurt & Kathryn E Muessig, 2017. "Exploring the HIV continuum of care among young black MSM," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-20, June.
    13. Atun, Rifat A. & Lebcir, Reda M. & McKee, Martin & Habicht, Jarno & Coker, Richard J., 2007. "Impact of joined-up HIV harm reduction and multidrug resistant tuberculosis control programmes in Estonia: System dynamics simulation model," Health Policy, Elsevier, vol. 81(2-3), pages 207-217, May.
    14. Yang, Lawrence H. & Purdie-Vaughns, Valerie & Kotabe, Hiroki & Link, Bruce G. & Saw, Anne & Wong, Gloria & Phelan, Jo C., 2013. "Culture, threat, and mental illness stigma: Identifying culture-specific threat among Chinese-American groups," Social Science & Medicine, Elsevier, vol. 88(C), pages 56-67.
    15. Hao Li & Ling Zheng & Hong Le & Lijun Zhuo & Qian Wu & Guoqing Ma & Hongbing Tao, 2020. "The Mediating Role of Internalized Stigma and Shame on the Relationship between COVID-19 Related Discrimination and Mental Health Outcomes among Back-to-School Students in Wuhan," IJERPH, MDPI, vol. 17(24), pages 1-14, December.
    16. 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.
    17. 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).
    18. Hsueh, Loretta & Layland, Eric K. & Kipke, Michele D. & Bray, Bethany C., 2021. "Linking racism and homonegativity to healthcare system distrust among young men of color who have sex with men: Evidence from the Healthy Young Men's (HYM) study," Social Science & Medicine, Elsevier, vol. 284(C).
    19. Josefien van Olmen, 2022. "The Promise of Digital Self-Management: A Reflection about the Effects of Patient-Targeted e-Health Tools on Self-Management and Wellbeing," IJERPH, MDPI, vol. 19(3), pages 1-9, January.
    20. Hannah Farrimond, 2023. "Stigma Mutation: Tracking Lineage, Variation and Strength in Emerging COVID-19 Stigma," Sociological Research Online, , vol. 28(1), pages 171-188, March.

    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:gam:jijerp:v:17:y:2020:i:6:p:1924-:d:332921. 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: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    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.