Examining a Syndemics Network Among Young Latino Men Who Have Sex with Men

Abstract

Background: Although studies consistently find that syndemic indicators are additively associated with increased HIV/STI risk behavior (e.g., condomless anal sex; CAS) among men who have sex with men (MSM), information is lacking about how syndemic indicators are associated with each other. Young Latino MSM are one of the most at-risk groups for acquiring HIV in the U.S. Understanding the associations of syndemic indicators with each other and with CAS may improve understanding of how to enhance sexual and behavioral health in this population.

Method: Network analysis using the graphical LASSO (glasso) algorithm was employed to explore associations between CAS and syndemic indicators among 139 young Latino MSM. Structural and psychosocial syndemic indicators were assessed via self-report. CAS was defined as the number of partners in the past 3 months with whom one engaged in CAS.

Results: Results of the network analysis suggested the variables with the highest centrality were unstable housing, prison history, childhood sexual abuse, and CAS. Specific significant associations included links between CAS and alcohol use (b = 0.40), childhood sexual abuse and unstable housing (b = - 0.75), alcohol use and childhood sexual abuse (b = 0.40), and substance use and intimate partner violence (b = 0.43).

Conclusion: This pattern of interconnectedness demonstrates the potential for network analysis to examine nuanced interrelationships of syndemic indicators. The specific associations in this sample raise the question whether a primary focus of interventions should address the more central syndemic indicators for this population, such as alcohol use and unstable housing, and whether this would, via downstream effects, affect other aspects of behavioral health in this population.

Keywords: HIV; Latino; Men who have sex with men; Network analysis; Syndemic indicators.

Fig. 1

Network analysis of condomless anal sex and nine syndemic indicators. Blue edges represent positive associations, whereas red edges represent negative associations. Thicker and darker edges indicate stronger associations than do thinner and lighter edges. * indicates a significant edge (pairwise association) between two nodes (i.e., CAS—ALC, SUB—IPV, ALC—CSA, HOU—CSA). For full node names, refer to the legend in the figure

Fig. 2

Centrality measures of each node in the network analysis. z-scores are presented on the x-axis for each centrality measure. Full node names are condomless anal sex (CAS), substance use (SUB), injection drug use (IDU), alcohol use (ALC), depression (DEP), intimate partner violence (IPV), childhood sexual abuse (CSA), poverty (POV), unstable housing (HOU), and prison history (PRI)