ArticleAIDS and behavior2019
High Levels of Syndemics and Their Association with Adherence, Viral Non-suppression, and Biobehavioral Transmission Risk in Miami, a U.S. City with an HIV/AIDS Epidemic.
Article in AIDS and behavior, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics.Journal of consulting and clinical psychology · 2023Pooled it
- Mlambe economic and relationship-strengthening intervention for alcohol use decreases violence and improves relationship quality in couples living with HIV in Malawi.Social science & medicine (1982) · 2024Trial
- Trial
- Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.Journal of the American Medical Informatics Association : JAMIA · 2023Trial
- A US-Based National Virtual Cohort of People Living With HIV at Risk for Viral Nonsuppression: Protocol for the EPI-LoVE Prospective Cohort Study.JMIR research protocols · 2026Article
- Differentiating Exposure From Consequence: A Longitudinal Examination of Trauma and Posttraumatic Distress in a Public HIV Care Clinic.AIDS and behavior · 2026Article
- Burden of mental health symptoms and access to needed mental health care among people with HIV in New England.AIDS care · 2026Article
- Structures of survival: Syndemic pathways to care among people with HIV involved with the criminal legal system.Social science & medicine (1982) · 2026Article
- Life Instability and Its Effects on Psychosocial Syndemic Problems and HIV-Care Outcomes in People Living With HIV in Care in South Florida.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Transgender Women in India: A Syndemic and Intersectional Framework Addressing HIV Care Gaps.American journal of public health · 2025Article
- Implementation of Trauma-Informed Care into Clinical HIV Prevention and Care Settings: A Decade of Limited Progress.Current HIV/AIDS reports · 2025Review
- 'Doing what I need to do': sustaining mental health, medication adherence, and engagement in care among Black women living with HIV during the COVID-19 onset of 2020.Ethnicity & health · 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
- The Utilization of Syndemic Theory in Transgender Literature: A Structured Literature Review.Transgender health · 2024Review
- A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa.Journal of behavioral medicine · 2024Article
- Medial prefrontal cortex connectivity with the nucleus accumbens is related to HIV serostatus, perceptions of psychological stress, and monocyte expression of TNF-a.Brain, behavior, & immunity - health · 2024Article
- Article
- Psychosocial Distress Among Young Men Who Have Sex With Men: A Scoping Review.Journal of psychosocial nursing and mental health services · 2024Article
- Factors associated with antiretroviral treatment adherence among people living with HIV in Guangdong Province, China: a cross sectional analysis.BMC public health · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Miami is a Southeastern United States (U.S.) city with high health, mental health, and economic disparities, high ethnic/racial diversity, low resources, and the highest HIV incidence and prevalence in the country. Syndemic theory proposes that multiple, psychosocial comorbidities synergistically fuel the HIV/AIDS epidemic. People living with HIV/AIDS in Miami may be particularly affected by this due to the unique socioeconomic context. From April 2017 to October 2018, 800 persons living with HIV/AIDS in a public HIV clinic in Miami completed an interviewer-administered behavioral and chart-review cross-sectional assessment to examine the prevalence and association of number of syndemics (unstable housing, low education, depression, anxiety, binge drinking, drug use, violence, HIV-related stigma) with poor ART adherence, unsuppressed HIV viral load (≥ 200 copies/mL), and biobehavioral transmission risk (condomless sex in the context of unsuppressed viral load). Overall, the sample had high prevalence of syndemics (M = 3.8), with almost everyone (99%) endorsing at least one. Each syndemic endorsed was associated with greater odds of: less than 80% ART adherence (aOR 1.64, 95% CI 1.38, 1.98); having unsuppressed viral load (aOR 1.16, 95% CI 1.01, 1.33); and engaging in condomless sex in the context of unsuppressed viral load (1.78, 95% CI 1.30, 2.46). The complex syndemic of HIV threatens to undermine the benefits of HIV care and are important to consider in comprehensive efforts to address the disproportionate burden of HIV/AIDS in the Southern U.S. Achieving the 90-90-90 UNAIDS and the recent U.S. "ending the epidemic" targets will require efforts addressing the structural, social, and other syndemic determinants of HIV treatment and prevention.
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