Retrospective Reports of Developmental Stressors, Syndemics, and Their Association with Sexual Risk Outcomes Among Gay Men

• Published in: Archives of sexual behavior Vol. 44; no. 7; pp. 1879 - 1889
• Main Authors: Tulloch, Tyler G., Rotondi, Nooshin K., Ing, Stanley, Myers, Ted, Calzavara, Liviana M., Loutfy, Mona R., Hart, Trevor A.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2015; Springer Nature B.V
• Subjects: Adult; Behavioral Science and Psychology; Bullying; Child abuse & neglect; HIV; Homosexuality, Male - psychology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Male; Men; Prevention; Psychology; Public Health; Retrospective Studies; Sexual Behavior; Sexual orientation; Social Sciences; Special Section: Sexual Health in Gay and Bisexual Men; Stress; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Unsafe Sex - psychology; Unsafe Sex - statistics & numerical data; Young Adult; Bullying; Childhood abuse; Sexual orientation; HIV prevention; Minority stress; Syndemics
• ISSN: 0004-0002; 1573-2800
• DOI: 10.1007/s10508-015-0479-3

Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questionnaires at baseline and 6-month follow-up. Syndemic variables included depression, polysubstance use, and intimate partner violence. Early life adversity variables measured retrospectively included physical and verbal bullying by peers and physical and sexual abuse by adults. A Cochran–Armitage trend test revealed a proportionate increase between number of syndemic problems and engagement in high-risk sex (
p
 < .0001), thereby supporting syndemic theory. All early life adversity variables were positively correlated with number of syndemic problems. A bootstrap mediation analysis revealed indirect effects of two types of early life adversity on high-risk sex via syndemic severity: verbal bullying by peers and physical abuse by adults. There was also an overall effect of physical bullying by peers on high-risk sexual behavior, but no specific direct or indirect effects were observed. Consistent with syndemic theory, results provide evidence that certain types of early life adversity impact high-risk sex later in life via syndemic problems. Behavioral interventions to reduce sexual risk among GBM should address anti-gay discrimination experienced before adulthood as well as adult psychological problems.