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Review
. 2022 Aug;9(8):e574-e584.
doi: 10.1016/S2352-3018(22)00076-5. Epub 2022 Jun 21.

Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men

Don Operario  1 , Shufang Sun  2 , Amiel Nazer Bermudez  3 , Rainier Masa  4 , Sylvia Shangani  5 , Elise van der Elst  6 , Eduard Sanders  7
Affiliations
Review

Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men

Don Operario et al. Lancet HIV. 2022 Aug.

Abstract

In this Series paper, we review evidence on the co-occurring and synergistic epidemics (syndemic) of HIV and mental health problems worldwide among men who have sex with men (MSM). The multilevel determinants of this global syndemic include structural factors that enable stigma, systematic bias, and violence towards MSM across geographical and cultural contexts. Cumulative exposure to these factors over time results in population-level inequities in the burden of HIV infections and mental health problems among MSM. Evidence for this syndemic among MSM is strongest in the USA, Canada, western Europe, and parts of Asia and Latin America, with emerging evidence from sub-Saharan Africa. Integrated interventions are needed to address syndemics of HIV and mental health problems that challenge the wellbeing of MSM populations worldwide, and such interventions should consider various mental health conditions (eg, depression, anxiety, trauma, and suicidality) and their unique expressions and relationships with HIV outcomes depending on cultural contexts. In addition, interventions should identify and intervene with locally relevant structural factors that result in HIV and mental health vulnerabilities among MSM.

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Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

Figure
Figure. Multilevel processes contributing to syndemics of HIV and mental health problems in men who have sex with men
The schematic is based on selected conceptual frameworks with aetiological examples from literature.
See this image and copyright information in PMC

Comment in

References

    1. Centers for Disease Control and Prevention. Pneumocystis pneumonia—Los Angeles. MMWR Morb Mortal Wkly Rep. 1981;30:1–3. - PubMed
    1. GBD 2019 HIV Collaborators. Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019. Lancet HIV. 2021;8:e633–51. - PMC - PubMed
    1. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380:367–77. - PMC - PubMed
    1. Coelho LE, Torres TS, Veloso VG, et al. The prevalence of HIV among men who have sex with men (MSM) and young MSM in Latin America and the Caribbean: a systematic review. AIDS Behav. 2021;25:3223–37. - PubMed
    1. Davlidova S, Haley-Johnson Z, Nyhan K, Farooq A, Vermund SH, Ali S. Prevalence of HIV, HCV and HBV in central Asia and the Caucasus: a systematic review. Int J Infect Dis. 2021;104:510–25. - PMC - PubMed

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