What constitutes a syndemic? Methods, contexts, and framing from 2019.

Area of Science:

• Public Health
• Epidemiology
• Social Sciences

Background:

• Syndemics represent the aggregation of two or more diseases whose interactions exacerbate their individual effects.
• Understanding syndemics is crucial for developing effective public health interventions.
• Research on HIV syndemics has grown, necessitating a review of current methodologies and findings.

Purpose of the Study:

• To systematically review methods used in 60 articles on HIV syndemics published in 2019.
• To identify geographical locations and syndemic clusters within these studies.
• To underscore the significance of syndemic research in the context of HIV.

Main Methods:

• Analysis of 60 articles on HIV syndemics from 2019.
• Categorization of research methodologies including regression analyses, qualitative interviews, and reviews.
• Mapping of study locations and identification of co-occurring health and social issues.

Main Results:

• Regression analyses were the most common method; higher-level modeling was less frequent.
• Key syndemic co-factors included substance abuse, sexual risk behaviors, mental health issues, violence, and stigma.
• Studies were predominantly conducted in the United States, with others in Canada, Kenya, Uganda, South Africa, India, and Peru.

Conclusions:

• Interventions for people with HIV must address interconnected factors like mental health, stigma, trauma, and sexual risk.
• An intersectoral approach is vital, considering social determinants such as sex, race, class, and past trauma.
• Future research should continue to explore the complex interplay of factors within HIV syndemics.