Syndemic Vulnerability, Sexual and Injection Risk Behaviors, and HIV Continuum of Care Outcomes in HIV-Positive Injection Drug Users

• Published in: AIDS and behavior Vol. 19; no. 4; pp. 684 - 693
• Main Authors: Mizuno, Yuko, Purcell, David W., Knowlton, Amy R., Wilkinson, James D., Gourevitch, Marc N., Knight, Kelly R.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.04.2015; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral Therapy, Highly Active; Cohort Studies; Continuity of Patient Care; Data collection; Drug abuse; Drug use; Female; Health Psychology; Health risks; HIV; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Infectious Diseases; Injection; Injections; Logistic Models; Male; Medication Adherence; Medicine; Medicine & Public Health; Middle Aged; Needle Sharing; Original Paper; Psychosocial factors; Public Health; Risk; Risk factors; Risk taking; Sexual behavior; Sexually transmitted diseases; STD; Substance Abuse, Intravenous - complications; Unsafe Sex; Vulnerability; New York; San Francisco California; United States > US; Baltimore Maryland; HIV risk behaviors; HIV continuum of care; HIV-positive injection drug users; Syndemics
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-014-0890-0

Limited investigations have been conducted on syndemics and HIV continuum of care outcomes. Using baseline data from a multi-site, randomized controlled study of HIV-positive injection drug users (n = 1,052), we examined whether psychosocial factors co-occurred, and whether these factors were additively associated with behavioral and HIV continuum of care outcomes. Experiencing one type of psychosocial problem was significantly ( p  < 0.05) associated with an increased odds of experiencing another type of problem. Persons with 3 or more psychosocial problems were significantly more likely to report sexual and injection risk behaviors and were less likely to be adherent to HIV medications. Persons with 4 or more problems were less likely to be virally suppressed. Reporting any problems was associated with not currently taking HIV medications. Our findings highlight the association of syndemics not only with risk behaviors, but also with outcomes related to the continuum of care for HIV-positive persons.