Psychiatric Consultation-Liaison Service, Legacy Health, Portland, OR, USA.
Department of Health Behavior and Biological Sciences, School of Nursing and Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
AIDS Behav. 2018 Dec;22(12):4019-4033. doi: 10.1007/s10461-018-2216-0.
In order to address common statistical and population-based limitations in epidemiological literature applying syndemic theory, this study uses latent class analysis (LCA) to explore how health and social problems coalesce and shape sexual risk behaviors linked to HIV transmission in three Mexico City prisons. Among the studied male inmates, LCA identified four classes, defined by low syndemic risk (61.4%); marijuana (14.3%); depression, substances, and trauma (19.7%); and depression, substances, and marijuana (4.7%). In multinomial regression models, classes with a greater number of syndemic exposures were associated with increased odds of condomless anal sex during incarceration. In analyses stratified by pre-incarceration sexual risk behaviors, however, high syndemic burden classes were associated with condomless anal sex during incarceration differently. Overall, the study findings suggest that LCA has potential utility for syndemic analyses and highlight the need to attend to health and social adversities when addressing sexual risk behaviors and HIV transmission during incarceration.
为了解决流行病学文献中应用综合征理论时常见的统计和基于人群的局限性，本研究使用潜在类别分析（LCA）来探讨健康和社会问题在三个墨西哥城监狱中如何融合并塑造与 HIV 传播相关的性风险行为。在所研究的男性囚犯中，LCA 确定了四个类别，由低综合征风险（61.4%）；大麻（14.3%）；抑郁、物质和创伤（19.7%）；以及抑郁、物质和大麻（4.7%）。在多项回归模型中，具有更多综合征暴露的类别与监禁期间无保护肛交的几率增加相关。然而，在按入狱前性风险行为分层的分析中，高综合征负担类别与监禁期间无保护肛交的关联方式不同。总体而言，研究结果表明，LCA 对综合征分析具有潜在的效用，并强调在解决监禁期间的性风险行为和 HIV 传播时需要关注健康和社会逆境。
