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Characterising a syndemic among black women at risk for HIV: the role of sociostructural inequity and adverse childhood experiences

Authors :
Kiyomi Tsuyuki
Erica Chan
Marguerite B Lucea
Andrea Cimino
Abby E Rudolph
Yordanos Tesfai
Jacquelyn C Campbell
Christina J Catabay
Jamila K Stockman
Source :
Sexually Transmitted Infections. 99:7-13
Publication Year :
2022
Publisher :
BMJ, 2022.

Abstract

ObjectivesBlack women disproportionately experience STIs (including HIV/AIDS), gender-based violence, substance misuse and mental health conditions. Addressing a gap in syndemic research, we characterised comorbidity overlap within the context of sociostructural inequities and adverse childhood experiences (ACEs) among black women in Baltimore, Maryland.MethodsBetween 2015 and 2018, black women (n=305) were recruited from STI clinics in Baltimore, Maryland. Among those with complete survey data (n=230), we conducted a latent class analysis to differentiate women based on their profile of the following syndemic comorbidities: STIs, adult sexual victimisation, substance misuse and mental health disorders. We then examined the association between ACEs and syndemic latent class membership.ResultsThirty-three percent of women experienced three to nine ACEs before age 18 years, and 44% reported four to six comorbidities. The two-class latent class solution demonstrated the best fit model, and women were categorised in either class 1 (past-year STI; 59%) or class 2 (syndemic comorbidities; 41%). Women in class 2 were more likely to report unstable housing (10% vs 3%) and identify as bisexual/gay (22% vs 10%) than women in class 1. ACEs were significantly associated with an increased likelihood of class 2 membership.ConclusionsThis study reinforces the importance of screening for ACEs and offering trauma-informed, integrated care for black women with syndemic comorbidities. It also highlights the critical nature of tailoring interventions to improve sociostructural equity, preventing and reducing syndemic development.

Subjects

Subjects :
Infectious Diseases
Dermatology

Details

ISSN :
14723263 and 13684973
Volume :
99
Database :
OpenAIRE
Journal :
Sexually Transmitted Infections
Accession number :
edsair.doi.dedup.....89b5712843611c998c622483aeb252fe
Full Text :
https://doi.org/10.1136/sextrans-2021-055224