Syndemics and HIV-related sexual risk among men who have sex with men in India

Influences of stigma and resilience

Bibliographic Data

ID15098596
AuthorsVenkatesan Chakrapani (0000-0001-9998-9135, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India), Manmeet Kaur (0000-0001-9843-2271, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India, corresponding author), P A Newman (0000-0003-0444-5915, University of Toronto), Sandeep Mittal (0000-0001-7653-9019, Chandigarh State AIDS Control Society, Chandigarh, India), Rajesh Kumar (0000-0001-9750-3437, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India)
Year2019
Volume21
Issue4
Pages416-431
Publication date2019-04-03
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueCulture Health & Sexuality (JOURNAL)
Journal identifiersISSN: 1369-1058 • E-ISSN: 1464-5351
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/13691058.2018.1486458
PMID30025511
OpenAlexW2884252078
LanguageEN
Citations received20
References cited47

Using syndemics theory as a framework, we explored the experience of men who have sex with men in India in relation to four syndemic conditions (depression, alcohol use, internalised homonegativity and violence victimisation) and to understand their resilience resources. Five focus groups were conducted among a purposive sample of diverse men along with seven key informant interviews with HIV service providers. Participants' narratives suggested various pathways by which syndemic conditions interact with one another to sequentially or concurrently increase HIV risk. Experiences of discrimination and violence from a range of perpetrators (family, ruffians and police) contributed to internalised homonegativity and/or depression, which in turn led some men to use alcohol as a coping strategy. Stigma related to same-sex sexuality, gender non-conformity and sex work contributed to the production of one or more syndemic conditions. While rejection by family and male regular partners contributed to depression/alcohol use, support from family, regular partners and peers served as resources of resilience. In India, HIV prevention and health promotion efforts among men who have sex with men could be strengthened by multi-level multi-component interventions to reduce intersectional/intersecting stigma, address syndemic conditions and foster resilience - especially by promoting family acceptance and peer support

Environmental health · Human sexuality · Men who have sex with men · Minority stress · Poison control · Psychiatry · Psychological intervention · Psychological resilience · Sex work · Sexual minority · Sexual orientation · Sociology · Suicide prevention · Syndemic · Syphilis · Victimisation · Clinical Psychology · Gender Studies · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Sex work and related issues · Social Psychology