Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;50(7):2825-2841.
doi: 10.1007/s10508-020-01850-4. Epub 2021 Jan 22.

Syndemic Profiles and Sexual Minority Men's HIV-Risk Behavior: A Latent Class Analysis

Jillian R Scheer  1 , Kirsty A Clark  2 , Anthony J Maiolatesi  2   3 , John E Pachankis  2   3
Affiliations

Syndemic Profiles and Sexual Minority Men's HIV-Risk Behavior: A Latent Class Analysis

Jillian R Scheer et al. Arch Sex Behav. 2021 Oct.

Abstract

Syndemic theory posits that "syndemic conditions" (e.g., alcohol misuse, polydrug use, suicidality) co-occur among sexual minority men and influence HIV-risk behavior, namely HIV acquisition and transmission risk. To examine how four syndemic conditions cluster among sexual minority men and contribute to HIV-risk behavior, we conducted latent class analysis (LCA) to: (1) classify sexual minority men (n = 937) into subgroups based on their probability of experiencing each syndemic condition; (2) examine the demographic (e.g., race/ethnicity) and social status (e.g., level of socioeconomic distress) characteristics of the most optimally fitting four syndemic classes; (3) examine between-group differences in HIV-risk behavior across classes; and (4) use syndemic class membership to predict HIV-risk behavior with sexual minority men reporting no syndemic conditions as the reference group. The four classes were: (1) no syndemic, (2) alcohol misuse and polydrug use syndemic, (3) polydrug use and HIV syndemic, and (4) alcohol misuse. HIV-risk behavior differed across these latent classes. Demographic and social status characteristics predicted class membership, suggesting that syndemic conditions disproportionately co-occur in vulnerable subpopulations of sexual minority men, such as those experiencing high socioeconomic distress. When predicting HIV-risk behavior, men in the polydrug use and HIV syndemic class were more likely (Adjusted Risk Ratio [ARR] = 2.93, 95% CI: 1.05, 8.21) and men in the alcohol misuse class were less likely (ARR = 0.17, 95% CI: 0.07, 0.44) to report HIV-risk behavior than were men in the no syndemic class. LCA represents a promising methodology to inform the development and delivery of tailored interventions targeting distinct combinations of syndemic conditions to reduce sexual minority men's HIV-risk behavior.

Keywords: HIV-risk behavior; Latent class analysis; Sexual minority men; Syndemic.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Conditional item probability profile plot for the four-class model of syndemic conditions
See this image and copyright information in PMC

References

    1. Baams L, Grossman AH, & Russell ST (2015). Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Developmental Psychology, 51(5), 680–696. - PMC - PubMed
    1. Bakk Z, Tekle FB, & Vermunt JK (2013). Estimating the association between latent class membership and external variables using bias-adjusted three-step approaches. Sociological Methodology, 43(1), 272–311.
    1. Benjamini Y, & Hochberg Y (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society Series B. Methodological, 57, 289–300.
    1. Blosnich J, & Bossarte R (2012). Drivers of disparity: Differences in socially based risk factors of self-injurious and suicidal behaviors among sexual minority college students. Journal of American College Health, 60(2), 141–149. - PMC - PubMed
    1. Boeri MW, Sterk CE, Bahora M, & Elifson KW (2008). Polydrug use among ecstasy users: Separate, synergistic, and indiscriminate patterns. Journal of Drug Issues, 38(2), 517–541. - PMC - PubMed

Publication types