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Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States.

ABSTRACT: BACKGROUND:Worldwide, young transgender women (YTW) contend with exceptionally high risks of HIV infection. Cross-sectional studies have suggested that co-occurring epidemics or "syndemics" of psychosocial problems may accelerate HIV acquisition and transmission through elevated sexual risk behavior among transgender women. We aimed to examine how a syndemic of 7 psychosocial problems potentiates HIV sexual risk behavior among a multicity, longitudinal cohort of sexually active YTW in the United States. METHODS:Between 2012 and 2015, 233 YTW from Boston, MA, and Chicago, IL, completed behavioral surveys at baseline, 4, 8, and 12 months. We used generalized estimating equations to examine the prospective relationship of overlapping psychosocial problems and HIV sexual risk behavior (ie, condomless anal or vaginal sex) among YTW. RESULTS:The prevalence of 7 psychosocial syndemic problems was substantial at baseline and remained high at each time point: 6.4% reported polydrug use in the past 4 months (excluding stimulants); 7.7% reported heavy alcohol use in the past 4 months; 10% reported a history of childhood sexual abuse; 15.9% reported stimulant use in the past 4 months; 41.7% reported experiencing lifetime intimate partner violence; 42.1% reported clinically significant depressive symptoms; and 68.6% reported lifetime transgender-specific victimization. We identified a statistically significant positive "dose-response" relationship between the number of psychosocial syndemic problems and condomless anal or vaginal sex over time. CONCLUSIONS:The accumulation of "syndemic" psychosocial problems predicted HIV sexual risk behavior in a prospective cohort of YTW. Given the high prevalence of psychosocial problems and HIV sexual risk behavior, as well as having the highest HIV incidence among any risk group, the HIV prevention agenda requires a shift toward improved assessment of psychosocial comorbidities and stronger integration with gender-affirming and supportive mental health, violence recovery, and addiction treatment services for this population.

SUBMITTER: Mimiaga MJ

PROVIDER: S-EPMC6522320 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States.

Mimiaga Matthew J MJ Hughto Jaclyn M W JMW Biello Katie B KB Santostefano Christopher M CM Kuhns Lisa M LM Reisner Sari L SL Garofalo Robert R

Journal of acquired immune deficiency syndromes (1999) 20190601 2

<h4>Background</h4>Worldwide, young transgender women (YTW) contend with exceptionally high risks of HIV infection. Cross-sectional studies have suggested that co-occurring epidemics or "syndemics" of psychosocial problems may accelerate HIV acquisition and transmission through elevated sexual risk behavior among transgender women. We aimed to examine how a syndemic of 7 psychosocial problems potentiates HIV sexual risk behavior among a multicity, longitudinal cohort of sexually active YTW in th ...[more]

PMID: 30839380

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Project description:BackgroundFew studies have explored the important role of different dimensions of emotional and behavioral problems (EBPs), perceived social support and loneliness in predicting suicidal ideation among Chinese adolescents. Based on a 6-month longitudinal study conducted in Taizhou high schools, we aimed to explore the associations between psychosocial problems and suicidal ideation in Chinese adolescents, and to ascertain whether co-occurring psychosocial problems increase suicidal ideation.MethodsA total of 3,267 students were eligible for this analysis. Perceived social support was assessed using the Multidimensional Scale of Perceived Social Support. Loneliness and suicidal ideation were assessed using the University of California, Los Angeles (UCLA) 3-Item Loneliness Scale and one item from the Children's Depression Inventory. The Strength and Difficulties Questionnaire assessed EBPs. Multivariable logistic regression models were used to estimate longitudinal associations between each psychosocial problem (lack of perceived social support from family, friends, and significant others, loneliness, emotional, conduct and peer problems, hyperactivity, and poor prosocial behavior) at baseline and suicidal ideation at follow-up. Multinomial logistic regression models were used to examine the association between the number of psychosocial problems at baseline and suicidal ideation at follow-up.ResultsThe multivariable logistic regression results showed that after adjusting for baseline suicidal ideation, sociodemographic covariates and depressive symptoms, low level of perceived social support from family (OR =1.78; 95% CI: 1.10-2.87), emotional problems (OR =2.35; 95% CI: 1.41-3.79), and poor prosocial behavior (OR =1.74; 95% CI: 1.08-2.79) were significant predictors of suicidal ideation among the adolescents. The risk of suicidal thoughts increased as the number of psychosocial problems increased. The participants with five or more psychosocial problems had a higher risk of having serious suicidal thoughts than those with no problem (relative risk ratio =4.50; 95% CI: 2.13-9.49).ConclusionsThe study confirmed the predictive role of multiple psychosocial problems on suicidal ideation, and the accumulative effect of co-occurring psychosocial problems in magnifying the risk of suicidal ideation. More integrated and holistic approaches need to be taken to identify high-risk groups and provide interventions of suicidality in adolescents.

Dataset Information

Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States.

Publications

Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States.

Similar Datasets

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