Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach.
Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach.
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DOI：
10.2105/ajph.2012.300810
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发表时间：
2013-01
影响因子：
12.7
通讯作者：
Stall R
中科院分区：
文献类型：
--
作者：
Herrick AL;Lim SH;Plankey MW;Chmiel JS;Guadamuz TE;Kao U;Shoptaw S;Carrico A;Ostrow D;Stall R
我们使用一项大型队列研究的数据，检验了男男性行为者（MSM）中的症状产生理论。参与者是来自多中心艾滋病队列研究的1551名男性，他们在4个研究中心登记：马里兰-华盛顿特区的巴尔的摩;伊利诺斯州的芝加哥;加州的洛杉矶;宾夕法尼亚州的匹兹堡。参与者从2008年4月1日到2009年3月31日参加了半年一次的访问，完成了一项额外的调查，该调查收集了他们一生中被认为与syndemic生产有关的事件的数据。使用多变量分析，我们发现大多数生命过程预测变量（例如，受害，内化的同性恋恐惧症）显着相关的综合征的条件和组成部分的心理健康结果（抑郁症状，压力，兴奋剂的使用，性强迫，亲密伴侣暴力）。巢式负二项分析显示，总体生命历程显著解释了综合征结局的变异性（χ2 = 247.94; P <0.001; df = 22）。我们确定了生命过程中的事件和条件相关的syndemic生产，这可能有助于通知创新的干预措施，将有效地解开相互关联的健康问题，促进男男性接触者的健康。
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 (χ2 = 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.