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Optimism and Education Buffer the Effects of Syndemic Conditions on HIV Status Among African American Men Who Have Sex with Men

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Abstract

The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., Am J Public Health, 93(6):939–942, 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two—optimism and education—buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors.

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Acknowledgments

The authors wish to recognize their funding source, the National Institute of Mental Health grant 1-R01-MH079736. We are grateful to many individuals who helped to bring this project to fruition, including Dr. Loretta S. Jemmott, Dr. Christopher Coleman, Janet Hsu, Brian Taylor, Mikia Croom, Pandora Woods, and Dennis Clegg. The findings and conclusions are those of the authors and do not necessarily reflect the official views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-37, Atlanta, GA, 30333, USA

    Ann O’Leary

  2. Department of Psychiatry, Perelman School of Medicine and Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA

    John B. Jemmott III

  3. Department of Childhood Studies, Rutgers University, Camden, NJ, USA

    Robin Stevens

  4. School of Social Work, Temple University, Philadelphia, PA, USA

    Scott Edward Rutledge & Larry D. Icard

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  1. Ann O’Leary
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  2. John B. Jemmott III
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  3. Robin Stevens
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  5. Larry D. Icard
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Correspondence to Ann O’Leary.

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O’Leary, A., Jemmott, J.B., Stevens, R. et al. Optimism and Education Buffer the Effects of Syndemic Conditions on HIV Status Among African American Men Who Have Sex with Men. AIDS Behav 18, 2080–2088 (2014). https://doi.org/10.1007/s10461-014-0708-0

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