Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Am J Public Health. 2013 Jan;103(1):79-85. doi: 10.2105/AJPH.2012.300810. Epub 2012 Nov 15.
We tested a theory of syndemic production among men who have sex with men (MSM) using data from a large cohort study.
Participants were 1551 men from the Multicenter AIDS Cohort Study enrolled at 4 study sites: Baltimore, Maryland-Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania. Participants who attended semiannual visits from April 1, 2008, to March 31, 2009, completed an additional survey that captured data about events throughout their life course thought to be related to syndemic production.
Using multivariate analysis, we found that the majority of life-course predictor variables (e.g., victimization, internalized homophobia) were significantly associated with both the syndemic condition and the component psychosocial health outcomes (depressive symptoms, stress, stimulant use, sexual compulsivity, intimate partner violence). A nested negative binomial analysis showed that the overall life course significantly explained variability in the syndemic outcomes (χ(2) = 247.94; P < .001; df = 22).
We identified life-course events and conditions related to syndemic production that may help to inform innovative interventions that will effectively disentangle interconnecting health problems and promote health among MSM.
我们使用来自大型队列研究的数据检验了男男性行为者（MSM）中综合征产生的理论。
参与者是来自四个研究地点（马里兰州巴尔的摩-华盛顿特区、伊利诺伊州芝加哥、加利福尼亚州洛杉矶和宾夕法尼亚州匹兹堡）的 1551 名参加多中心艾滋病队列研究的男性。从 2008 年 4 月 1 日至 2009 年 3 月 31 日，参加半年一次访问的参与者完成了一项额外的调查，该调查记录了他们整个生命历程中与综合征产生有关的事件的数据。
使用多变量分析，我们发现大多数生命历程预测变量（例如，受害、内化的同性恋恐惧症）与综合征状况以及心理社会健康结果（抑郁症状、压力、兴奋剂使用、性强迫、亲密伴侣暴力）都有显著关联。嵌套负二项式分析表明，整个生命历程显著解释了综合征结果的可变性（χ²=247.94；P<.001；df=22）。
我们确定了与综合征产生相关的生命历程事件和条件，这些事件和条件可能有助于提供创新的干预措施，有效地解决相互关联的健康问题，并促进 MSM 的健康。
