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. 2012 Sep;102(9):1751-7.
doi: 10.2105/AJPH.2011.300433. Epub 2012 Feb 16.

Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization

Julia Brennan  1 , Lisa M Kuhns, Amy K Johnson, Marvin Belzer, Erin C Wilson, Robert Garofalo; Adolescent Medicine Trials Network for HIV/AIDS Interventions
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Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization

Julia Brennan et al. Am J Public Health. 2012 Sep.

Abstract

Objectives: We assessed whether multiple psychosocial factors are additive in their relationship to sexual risk behavior and self-reported HIV status (i.e., can be characterized as a syndemic) among young transgender women and the relationship of indicators of social marginalization to psychosocial factors.

Methods: Participants (n = 151) were aged 15 to 24 years and lived in Chicago or Los Angeles. We collected data on psychosocial factors (low self-esteem, polysubstance use, victimization related to transgender identity, and intimate partner violence) and social marginalization indicators (history of commercial sex work, homelessness, and incarceration) through an interviewer-administered survey.

Results: Syndemic factors were positively and additively related to sexual risk behavior and self-reported HIV infection. In addition, our syndemic index was significantly related to 2 indicators of social marginalization: a history of sex work and previous incarceration.

Conclusions: These findings provide evidence for a syndemic of co-occurring psychosocial and health problems in young transgender women, taking place in a context of social marginalization.

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