Intersecting Relationships of Psychosocial and Structural Syndemic Problems Among People with HIV in South Africa: Using Network Analysis to Identify Influential Problems.

Autor: Lee JS; Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Sq, 7th Floor, Boston, MA, 02114, USA. JLEE333@mgh.harvard.edu.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. JLEE333@mgh.harvard.edu., Bainter SA; Department of Psychology, University of Miami, Coral Gables, FL, USA., Tsai AC; Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Andersen LS; Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Stanton AM; Department of Psychology, Boston University, Boston, MA, USA., Magidson JF; Department of Psychology, University of Maryland, College Park, MD, USA., Kagee A; Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa., Joska JA; HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa., O'Cleirigh C; Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Sq, 7th Floor, Boston, MA, 02114, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA., Safren SA; Department of Psychology, University of Miami, Coral Gables, FL, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2023 Jun; Vol. 27 (6), pp. 1741-1756. Date of Electronic Publication: 2022 Oct 30.
DOI: 10.1007/s10461-022-03906-z
Abstrakt: In South Africa, little is known about interrelationships between syndemic problems among people with HIV (PWH). A better understanding of syndemic problems may yield important information regarding factors amenable to mitigation. We surveyed 194 PWH in Khayelitsha, outside of Cape Town, South Africa. We used network analysis to examine the frequency of 10 syndemic problems and their interrelationships. Syndemic problems among PWH in South Africa were common; 159 (82.8%) participants reported at least 2 co-occurring syndemic problems and 90 (46.9%) endorsed 4 or more. Network analysis revealed seven statistically significant associations. The most central problems were depression, substance use, and food insecurity. Three clusters of syndemics were identified: mood and violence; structural factors; and behavioral factors. Depression, substance use, and food insecurity commonly co-occur among PWH in sub-Saharan Africa and interfere with HIV outcomes. Network analysis can identify intervention targets to potentially improve HIV treatment outcomes.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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