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HIV Syndemic Factor Associations Among Adolescent Gay and Bisexual Men in the Youth Risk Behavior Survey 2015-2019: A
David R Garcia1, Jason Fletcher, Lloyd Goldsamt
1David R. Garcia, PhD, FNP-BC, NP-C, is an Assistant Professor and Provost's Postdoctoral Research Fellow, Rory Meyers College of Nursing, New York University, New York, New York, USA. Jason Fletcher, PhD, is a Senior Biostatistician, Rory Meyers College of Nursing, New York University, New York, New York, USA. Lloyd Goldsamt, PhD, is a Senior Research Scientist, Rory Meyers College of Nursing, New York University, New York, New York, USA. David L. Bell, MD, MPH, is a Professor, Population and Family Health and Pediatrics, Columbia University Medical Center, New York, New York, USA. Yaguang Zheng, PhD, RN, is an Assistant Professor, Rory Meyers College of Nursing, New York University, New York, New York, USA. Ann-Margaret Dunn Navarra, PhD, CPNP-PC, FAAN, is an Assistant Professor, Rory Meyers College of Nursing, New York University, New York, New York, USA.
Abstract:
This analysis of the Youth Risk Behavior Survey examined HIV syndemic factor associations (substance use, violence, mental health, and HIV risk behaviors) among adolescent gay, bisexual, and other men who have sex with men-a population with the highest prevalence of undiagnosed HIV infections. The representative sample ( n = 644) exhibited low condom use (52%) and HIV testing (21%). Adjusted multivariate logistic regression models showed that Blacks were less likely to report HIV testing (adjusted odds ratio [aOR] = 0.06, 95% confidence interval [CI] [0.01-0.44], p < .01), whereas Hispanics were more likely to report four or more lifetime sexual partners (aOR = 3.75, 95% CI [1.49-9.44], p < .01), compared with Whites. A syndemic of substance use and intimate partner violence (sexual, sexual dating, and/or physical dating violence) was associated with early intercourse, multiple sexual partners, and drugs/alcohol before intercourse. Multiple syndemic factor exposures were associated with additive risk, suggesting multilevel approaches for HIV prevention.
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