Observational studyAIDS (London, England)2015
Effects of syndemics on HIV viral load and medication adherence in the multicentre AIDS cohort study.
Observational study in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
119 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Disparities in Awareness, Willingness and Uptake of Biomedical HIV Prevention Among Bisexual and Gay Men: A Systematic Review and Meta-Analysis.Journal of the International AIDS Society · 2026Pooled it
- Syndemics and clinical impact of HIV and mental health conditions among people living with HIV: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- eHealth Interventions to Address Sexual Health, Substance Use, and Mental Health Among Men Who Have Sex With Men: Systematic Review and Synthesis of Process Evaluations.Journal of medical Internet research · 2021Pooled it
- Critical Review: When the Party is Over: A Systematic Review of Behavioral Interventions for Substance-Using Men Who Have Sex with Men.Journal of acquired immune deficiency syndromes (1999) · 2016Pooled it
- Characterizing the Role of Neighborhood Disadvantage in a Digital PrEP Intervention for Young Sexual and Gender Minority Men.AIDS and behavior · 2026Trial
- The Effect of the Shikamana Peer-and-Provider Intervention on Depressive Symptoms, Alcohol Use, and Other Drug Use Among Gay, Bisexual, and Other Men Who Have Sex with Men in Kenya.AIDS and behavior · 2023Trial
- Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam.AIDS and behavior · 2022Trial
- The longitudinal association between depression, anxiety symptoms and HIV outcomes, and the modifying effect of alcohol dependence among ART clients with hazardous alcohol use in Vietnam.Journal of the International AIDS Society · 2021Trial
- Trial
- Optimizing Pre-Exposure Antiretroviral Prophylaxis Adherence in Men Who Have Sex with Men: Results of a Pilot Randomized Controlled Trial of "Life-Steps for PrEP".AIDS and behavior · 2017Trial
- Does substance use compromise depression treatment in persons with HIV? Findings from a randomized controlled trial.AIDS care · 2017Trial
- Sexualized alcohol and drug use among men who have sex with men and the PrEP retention in Thailand.Drug and alcohol dependence reports · 2026Article
- Development of the organizational trauma resilience-patient reported experience measure for people with HIV in the Southern United States.Psychological trauma : theory, research, practice and policy · 2025Article
- Article
- Exploring Co-production as an Implementation Strategy for Trauma-Informed Care in a Youth-Focused HIV Clinic in Memphis, Tennessee: Mixed Methods Research.JMIR formative research · 2025Article
- Neighborhood Disadvantage, Syndemic Conditions, and PrEP Non-Adherence in Young Sexual and Gender Minority Men.AIDS and behavior · 2025Article
- Transgender Women in India: A Syndemic and Intersectional Framework Addressing HIV Care Gaps.American journal of public health · 2025Article
- COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South.International journal of environmental research and public health · 2025Article
- The Longitudinal Impact of Psychosocial Syndemic Variables on Adherence to Antiretroviral Therapy Among People With HIV in Brazil, Thailand, and Zambia: An Analysis by HIV Transmission Groups in HPTN 063.AIDS education and prevention : official publication of the International Society for AIDS Education · 2025Article
- The impact of syndemic burden, age, and sexual minority status on internalized HIV stigma among people living with HIV in South Florida.Journal of health psychology · 2025Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectivesThe objective of this study is to determine associations between intertwining epidemics (syndemics) and HIV medication adherence and viral load levels among HIV-positive MSM and to test whether adherence mediates the relationship between syndemics and viral load.
designWe analysed participant data collected between 2003 and 2009 from the Multicenter AIDS Cohort Study, a prospective HIV/AIDS cohort study in four U.S. cities.
methodsWe conducted longitudinal analyses (repeated measures mixed models) to assess whether differences in viral load levels, undetectable viral load and self-reported HIV medication adherence were associated with count of syndemic conditions (substance use, depression symptoms and sexual risk behaviour, range 0-3), adjusting for race/ethnicity, age and income. Mediation analyses were conducted using structural equation modelling and the SAS %mediate macro.
resultsSyndemics count was associated with higher viral loads (P < 0.0001) and lower adherence (P < 0.0001). Increased counts of concomitant syndemics were associated with viral load (P < 0.01), detectable viral load (P < 0.05) and adherence (P < 0.001). Black MSM experienced worse outcomes across domains than white MSM (P < 0.0001) and experienced higher overall rates of syndemics (P < 0.01). Adherence significantly mediated the relationship between syndemics and viral load, accounting for an estimated 32.3% of the effect (P < 0.05).
conclusionEffectively lowering viral load levels among MSM has implications for both HIV/AIDS prevention and care. Our findings suggest that integrating substance use interventions, mental healthcare and sexual risk prevention into standard HIV care may be necessary to optimize treatment and Treatment as Prevention (TasP) models.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.