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Published in: International Journal of Behavioral Medicine 3/2019

01-06-2019 | Human Immunodeficiency Virus

Psychosocial Syndemics and Sexual Risk Practices Among U.S. Adolescents: Findings from the 2017 U.S. Youth Behavioral Survey

Authors: Moses Okumu, Bernadette K. Ombayo, Eusebius Small, David Ansong

Published in: International Journal of Behavioral Medicine | Issue 3/2019

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Abstract

Background

The present study aims to (1) identify classes of psychosocial syndemics among adolescents in the U.S. based on psychological factors, such as depression and suicidal ideation, and social factors, such as binge drinking, alcohol use, and drug use; (2) identify correlates of psychosocial syndemics; and (3) examine the independent associations between psychosocial syndemic factors and sexual risk practices.

Method

We used latent class analysis and a sample of 14,762 U.S. high school students who participated in the 2017 Youth Risk Behavior Surveillance System to examine youth population profiles based on shared characteristics of syndemics. Adjusting for sociodemographic factors, we conducted logistic regression to explore the connections between psychosocial syndemic factors and three sexual risk practices, namely, early initiation of sexual intercourse, condom use, and sex with multiple partners.

Results

The study results indicate that three classes of risk exist among the sample: substance misuse (class 1, n = 3872, 26.2%), normative (class 2, n = 8791, 59.6%), and mental health problems (class 3, n = 2099, 14.2%). Class membership of psychosocial syndemics was significantly different by gender, age group, and race. The odds of initiating sexual intercourse before age 13 were positively associated with participants belonging in the substance misuse class and the mental health problem class. The odds of using condoms during the last sexual intercourse for currently sexually active adolescents were lower for participants classified in the substance misuse class. The likelihood of reporting having sex with four or more partners in a lifetime was higher among participants belonging to the substance misuse class.

Conclusion

The study advances our understanding of the heterogeneity of class membership associated with psychosocial syndemic risk factors among adolescents and extends our understanding of syndemics in the area of adolescent health. Thus, practitioners and policymakers can design multicomponent and multilevel school-based HIV/STI prevention programs that meet the needs of adolescents.
Literature
12.
go back to reference Brennan J, Kuhns LM, Johnson AK, Belzer M, Wilson EC, Garofalo R, et al. Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization. Am J Public Health. 2012;102(9):1751–7.CrossRefPubMedPubMedCentral Brennan J, Kuhns LM, Johnson AK, Belzer M, Wilson EC, Garofalo R, et al. Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization. Am J Public Health. 2012;102(9):1751–7.CrossRefPubMedPubMedCentral
13.
go back to reference Dyer TP, Shoptaw S, Guadamuz TE, Plankey M, Kao U, Ostrow D, et al. Application of syndemic theory to Black men who have sex with men in the Multicenter AIDS Cohort Study. J Urban Health. 2012;89(4):697–708.CrossRefPubMedPubMedCentral Dyer TP, Shoptaw S, Guadamuz TE, Plankey M, Kao U, Ostrow D, et al. Application of syndemic theory to Black men who have sex with men in the Multicenter AIDS Cohort Study. J Urban Health. 2012;89(4):697–708.CrossRefPubMedPubMedCentral
14.
go back to reference Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.CrossRefPubMedPubMedCentral Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.CrossRefPubMedPubMedCentral
15.
go back to reference Starks TJ, Millar BM, Eggleston JJ, Parsons JT. Syndemic factors associated with HIV risk for gay and bisexual men: comparing latent class and latent factor modeling. AIDS Behav. 2014;18(11):2075–9.CrossRefPubMed Starks TJ, Millar BM, Eggleston JJ, Parsons JT. Syndemic factors associated with HIV risk for gay and bisexual men: comparing latent class and latent factor modeling. AIDS Behav. 2014;18(11):2075–9.CrossRefPubMed
16.
go back to reference Mustanski B, Van Wagenen A, Birkett M, Eyster S, Corliss HL. Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007. Am J Public Health. 2014;104(2):211–7.CrossRefPubMedPubMedCentral Mustanski B, Van Wagenen A, Birkett M, Eyster S, Corliss HL. Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007. Am J Public Health. 2014;104(2):211–7.CrossRefPubMedPubMedCentral
17.
go back to reference Martinez I, Ickovics JR, Keene DE, Perez-Escamilla R, Kershaw TS. Longitudinal evaluation of syndemic risk dyads in a cohort of young pregnant couples. J Adolesc Health. 2018;63(2):189–96.CrossRefPubMedPubMedCentral Martinez I, Ickovics JR, Keene DE, Perez-Escamilla R, Kershaw TS. Longitudinal evaluation of syndemic risk dyads in a cohort of young pregnant couples. J Adolesc Health. 2018;63(2):189–96.CrossRefPubMedPubMedCentral
18.
go back to reference Tsai AC, Burns BFO. Syndemics of psychosocial problems and HIV risk: a systematic review of empirical tests of the disease interaction concept. Soc Sci Med. 2015;139:26–35.CrossRefPubMedPubMedCentral Tsai AC, Burns BFO. Syndemics of psychosocial problems and HIV risk: a systematic review of empirical tests of the disease interaction concept. Soc Sci Med. 2015;139:26–35.CrossRefPubMedPubMedCentral
20.
go back to reference Pitpitan EV, Strathdee SA, Semple SJ, Chavarin CV, Magis-Rodriguez C, Patterson TL. Buffering syndemic effects in a sexual risk-reduction intervention for male clients of female sex workers: results from a randomized controlled trial. Am J Public Health. 2015;105:1866–71.CrossRefPubMedPubMedCentral Pitpitan EV, Strathdee SA, Semple SJ, Chavarin CV, Magis-Rodriguez C, Patterson TL. Buffering syndemic effects in a sexual risk-reduction intervention for male clients of female sex workers: results from a randomized controlled trial. Am J Public Health. 2015;105:1866–71.CrossRefPubMedPubMedCentral
21.
go back to reference Gilbert L, Raj A, Hien D, et al. Targeting the SAVA (substance abuse, violence and AIDS) syndemic among women and girls: a global review of epidemiology and integrated interventions. JAIDS. 2015;69(suppl 2):S118–27.PubMed Gilbert L, Raj A, Hien D, et al. Targeting the SAVA (substance abuse, violence and AIDS) syndemic among women and girls: a global review of epidemiology and integrated interventions. JAIDS. 2015;69(suppl 2):S118–27.PubMed
22.
go back to reference Newman PA, Zimmerman MA. Gender differences in HIV-related sexual risk behavior among urban African American youth: a multivariate approach. AIDS Educ Prev. 2000;12(4):308–25.PubMed Newman PA, Zimmerman MA. Gender differences in HIV-related sexual risk behavior among urban African American youth: a multivariate approach. AIDS Educ Prev. 2000;12(4):308–25.PubMed
24.
go back to reference Chirinda W, Peltzer K, Ramlagan S, Louw JS. Early sexual debut and associated risk factors among male and female youth in South Africa. J Psychol Afr. 2012;22(4):601–6.CrossRef Chirinda W, Peltzer K, Ramlagan S, Louw JS. Early sexual debut and associated risk factors among male and female youth in South Africa. J Psychol Afr. 2012;22(4):601–6.CrossRef
26.
go back to reference Becker ML, Bhattacharjee P, Blanchard JF, et al. Vulnerabilities at first sex and their association with lifetime gender-based violence and HIV prevalence among adolescent girls and young women engaged in sex work, transactional sex, and casual sex in Kenya. JAIDS. 2018;79(3):296–304.PubMed Becker ML, Bhattacharjee P, Blanchard JF, et al. Vulnerabilities at first sex and their association with lifetime gender-based violence and HIV prevalence among adolescent girls and young women engaged in sex work, transactional sex, and casual sex in Kenya. JAIDS. 2018;79(3):296–304.PubMed
29.
go back to reference Cleland CM, Lanza ST, Vasilenko SA, Gwadz M. Syndemic risk classes and substance use problems among adults in high-risk urban areas: a latent class analysis. Front Public Health. 2017;5:237.CrossRefPubMedPubMedCentral Cleland CM, Lanza ST, Vasilenko SA, Gwadz M. Syndemic risk classes and substance use problems among adults in high-risk urban areas: a latent class analysis. Front Public Health. 2017;5:237.CrossRefPubMedPubMedCentral
30.
go back to reference Robinson AC, Knowlton AR, Gielen AC, Gallo JJ. Substance use, mental illness, and familial conflict non-negotiation among HIV-positive African-Americans: latent class regression and a new syndemic framework. J Behav Med. 2016;39:1–12.CrossRefPubMed Robinson AC, Knowlton AR, Gielen AC, Gallo JJ. Substance use, mental illness, and familial conflict non-negotiation among HIV-positive African-Americans: latent class regression and a new syndemic framework. J Behav Med. 2016;39:1–12.CrossRefPubMed
32.
go back to reference Bennett DA. How can I deal with missing data in my study? Aust N Z J Public Health. 2001 Oct;25(5):464–9.CrossRefPubMed Bennett DA. How can I deal with missing data in my study? Aust N Z J Public Health. 2001 Oct;25(5):464–9.CrossRefPubMed
38.
go back to reference Logie CH, Lys C, Okumu M, et al. Pathways between depression, substance use and multiple sex partners among northern and indigenous young women in the Northwest Territories, Canada: results from a crosssectional survey. Sex Transm Infect. 2017. https://doi.org/10.1136/sextrans2017-053265. Logie CH, Lys C, Okumu M, et al. Pathways between depression, substance use and multiple sex partners among northern and indigenous young women in the Northwest Territories, Canada: results from a crosssectional survey. Sex Transm Infect. 2017. https://​doi.​org/​10.​1136/​sextrans2017-053265.
Metadata
Title
Psychosocial Syndemics and Sexual Risk Practices Among U.S. Adolescents: Findings from the 2017 U.S. Youth Behavioral Survey
Authors
Moses Okumu
Bernadette K. Ombayo
Eusebius Small
David Ansong
Publication date
01-06-2019
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 3/2019
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-019-09783-6

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