Understanding HIV Risk Behaviors Among Young Men in South Africa: A Syndemic Approach

Chukwuemeka N. Okafor; Joan Christodoulou; Jason Bantjes; Tembinkosi Qondela; Jackie Stewart; Steve Shoptaw; Mark Tomlinson; Mary Jane Rotherman-Borus

doi:10.1007/s10461-018-2227-x

Understanding HIV Risk Behaviors Among Young Men in South Africa: A Syndemic Approach

Chukwuemeka N. Okafor^*, Joan Christodoulou, Jason Bantjes, Tembinkosi Qondela, Jackie Stewart, Steve Shoptaw, Mark Tomlinson, Mary Jane Rotherman-Borus

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

Abstract

Young men in South Africa experience several adverse socio-structural and psychosocial factors that may contribute HIV risk behaviors. This study applied a syndemic framework to explore whether these syndemic factors are interconnected and work in synergy to increase HIV risk behaviors. Five syndemic factors were assessed including: binge drinking, polydrug use, depressive symptoms, violence and food insecurity on two HIV risk behaviors: multiple sex partners and transactional sex. Participants were (N = 1233) young men aged 18–29 years from a township in Cape Town, South Africa. Bivariate logistic regression analysis demonstrated that many of the syndemic factors were related to one another. Pairwise interactions (on an additive scale) among the syndemic factors revealed significant positive interactions between binge drinking and violence on greater odds of reporting multiple sex partners (aOR = 5.10, 95% CI 3.10, 8.29; p = <.001) compared to reporting neither factor. Also, food insecurity and violence (aOR = 2.89, 95% CI 1.63, 5.11; p = <.001) as well as food insecurity and polydrug use (aOR = 2.73, 95% CI 1.54, 4.84; p = <.001) were significantly associated with greater odds of transactional sex compared to reporting neither factor. Our findings highlight a synergistic relationship between some adverse socio-structural and psychosocial factors on HIV risk behaviors. HIV prevention programs that address multiple syndemic factors simultaneously may achieve greater impact on HIV risk reduction.

Original language	English
Pages (from-to)	3962-3970
Number of pages	9
Journal	AIDS and Behavior
Volume	22
Issue number	12
Early online date	12 Jul 2018
DOIs	https://doi.org/10.1007/s10461-018-2227-x
Publication status	Published - 01 Dec 2018
Externally published	Yes

Bibliographical note

Funding Information:
This project was supported by the National Institute on Drug Abuse (R34DA030311) and the National Research Foundation, South Africa. CNO is supported by the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research (T32MH080634; PIs: Currier and Gorbach). SS is supported by NIMH P30 058107?CHIPTS UCLA CFAR grant AI028697. MT is supported by the National Research Foundation, South Africa and is a Lead Investigator of the Centre of Excellence in Human Development, University Witwatersrand, South Africa. All authors declare that they have no conflict of interest.

Funding Information:
Acknowledgements This project was supported by the National Institute on Drug Abuse (R34DA030311) and the National Research Foundation, South Africa. CNO is supported by the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research (T32MH080634; PIs: Currier and Gorbach). SS is supported by NIMH P30 058107—CHIPTS UCLA CFAR grant AI028697. MT is supported by the National Research Foundation, South Africa and is a Lead Investigator of the Centre of Excellence in Human Development, University Witwatersrand, South Africa.

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

Alcohol
HIV risk
HIV risk behaviors
South Africa
Syndemics

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10461-018-2227-xLicence: Unspecified

Cite this

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abstract = "Young men in South Africa experience several adverse socio-structural and psychosocial factors that may contribute HIV risk behaviors. This study applied a syndemic framework to explore whether these syndemic factors are interconnected and work in synergy to increase HIV risk behaviors. Five syndemic factors were assessed including: binge drinking, polydrug use, depressive symptoms, violence and food insecurity on two HIV risk behaviors: multiple sex partners and transactional sex. Participants were (N = 1233) young men aged 18–29 years from a township in Cape Town, South Africa. Bivariate logistic regression analysis demonstrated that many of the syndemic factors were related to one another. Pairwise interactions (on an additive scale) among the syndemic factors revealed significant positive interactions between binge drinking and violence on greater odds of reporting multiple sex partners (aOR = 5.10, 95% CI 3.10, 8.29; p = <.001) compared to reporting neither factor. Also, food insecurity and violence (aOR = 2.89, 95% CI 1.63, 5.11; p = <.001) as well as food insecurity and polydrug use (aOR = 2.73, 95% CI 1.54, 4.84; p = <.001) were significantly associated with greater odds of transactional sex compared to reporting neither factor. Our findings highlight a synergistic relationship between some adverse socio-structural and psychosocial factors on HIV risk behaviors. HIV prevention programs that address multiple syndemic factors simultaneously may achieve greater impact on HIV risk reduction.",

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note = "Funding Information: This project was supported by the National Institute on Drug Abuse (R34DA030311) and the National Research Foundation, South Africa. CNO is supported by the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research (T32MH080634; PIs: Currier and Gorbach). SS is supported by NIMH P30 058107?CHIPTS UCLA CFAR grant AI028697. MT is supported by the National Research Foundation, South Africa and is a Lead Investigator of the Centre of Excellence in Human Development, University Witwatersrand, South Africa. All authors declare that they have no conflict of interest. Funding Information: Acknowledgements This project was supported by the National Institute on Drug Abuse (R34DA030311) and the National Research Foundation, South Africa. CNO is supported by the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research (T32MH080634; PIs: Currier and Gorbach). SS is supported by NIMH P30 058107—CHIPTS UCLA CFAR grant AI028697. MT is supported by the National Research Foundation, South Africa and is a Lead Investigator of the Centre of Excellence in Human Development, University Witwatersrand, South Africa. Publisher Copyright: {\textcopyright} 2018, Springer Science+Business Media, LLC, part of Springer Nature.",

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Understanding HIV Risk Behaviors Among Young Men in South Africa: A Syndemic Approach

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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