Identifying Syndemic Factors and Their Effect on HIV Sexual Risk Behavior Among Gay, Bisexual and Other Men Who Have Sex with Men in Vancouver, Montreal and Toronto.
IF 2.7 2区 医学Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Felipe Duailibe, Tian Shen, Wendy Zhang, David Moore, Mark Hull, Justin Barath, Carly Magee, Nathan Lachowsky, Trevor Hart, Joseph Cox, Daniel Grace, Gilles Lambert, Shayna Skakoon-Sparling, Jody Jollimore, Milada Dvorakova, Aki Gormezano, Viviane Dias Lima
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引用次数: 0
Abstract
We set out to identify syndemic factors associated with HIV sexual risk behavior among HIV-negative gay, bisexual and other men who have sex with men (GBM), and examine associations between syndemic factors and HIV sexual risk behaviors using models of co-occurring epidemics. We used baseline data from 1571 sexually active GBM from the Engage Cohort study, recruited using respondent-driven sampling in Montreal, Toronto, and Vancouver. We explored associations between potential syndemic factors and HIV sexual risk behavior, and used oblique component analysis to reduce the number of variables. Path analysis and logistic regression with interaction terms were used to evaluate the association of syndemic factors with HIV sexual risk behavior. In the mediation model, childhood sexual abuse (CSA) was associated with HIV sexual risk behavior (total effect: c = 0.14, 95% CI 0.06-0.21). This effect was mediated by any intimate partner violence (IPV), transactional sex, polysubstance use, and sexual compulsivity. We observed a multiplicative interaction between CSA and transactional sex: GBM with a history of both had 14 times the odds of HIV sexual risk behavior (aOR of 14.0 95% CI 5.6-35.2) compared to those with neither. The appropriate application of a syndemic approach allowed a nuanced assessment of syndemic factor associations with HIV sexual risk behavior. IPV, transactional sex, sexual compulsivity, and polysubstance use mediated the effect of CSA on HIV sexual risk behavior. Additionally, we found a significant multiplicative interaction between CSA and transactional sex.
我们开始在HIV阴性的男同性恋、双性恋和其他男男性行为者(GBM)中确定与HIV性风险行为相关的综合征因素,并使用共同发生的流行病模型检查综合征因素与HIV性风险行为之间的关联。我们使用了来自Engage队列研究的1571名性活跃GBM的基线数据,这些数据来自蒙特利尔、多伦多和温哥华的受访者驱动抽样。我们探讨了潜在的综合征因素与HIV性风险行为之间的关系,并使用斜成分分析来减少变量的数量。采用通径分析和带交互项的logistic回归评价综合征因素与HIV性危险行为的相关性。在中介模型中,儿童期性虐待(CSA)与HIV性风险行为相关(总效应:c = 0.14, 95% CI 0.06-0.21)。这种影响被任何亲密伴侣暴力(IPV)、交易性行为、多种物质使用和性强迫所介导。我们观察到CSA和交易性行为之间的乘法交互作用:有这两种病史的GBM发生HIV性风险行为的几率是没有这两种病史的人的14倍(aOR为14.0,95% CI 5.6-35.2)。适当应用综合征方法可以对与艾滋病毒性风险行为相关的综合征因素进行细致的评估。IPV、交易性行为、性强迫和多物质使用介导了CSA对HIV性风险行为的影响。此外,我们发现CSA和交易性之间存在显著的乘法交互作用。
期刊介绍:
AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76