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

Journal: AIDS and behavior

Volume: 27

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Sq, th Floor, Boston, MA, , USA. JLEE@mgh.harvard.edu. Department of Psychology, University of Miami, Coral Gables, FL, USA. Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA. Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Department of Psychology, Boston University, Boston, MA, USA. Department of Psychology, University of Maryland, College Park, MD, USA. Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa. HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Sq, th Floor, Boston, MA, , USA.

Abstract summary 

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.

Authors & Co-authors:  Lee Jasper S JS Bainter Sierra A SA Tsai Alexander C AC Andersen Lena S LS Stanton Amelia M AM Magidson Jessica F JF Kagee Ashraf A Joska John A JA O'Cleirigh Conall C Safren Steven A SA

Study Outcome 

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Statistics
Citations :  UNAIDS. South Africa [Internet]. 2018. [cited 2018 Nov 6]. Available from: http://www.unaids.org/en/regionscountries/countries/southafrica
Authors :  10
Identifiers
Doi : 10.1007/s10461-022-03906-z
SSN : 1573-3254
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Global Mental Health;HIV;Network analysis;Syndemics
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States