A syndemic of psychosocial health problems is associated with increased HIV sexual risk among Nigerian gay, bisexual, and other men who have sex with men (GBMSM)

ABSTRACT

Nigerian gay, bisexual and other men who have sex with men (GBMSM) experience negative psychosocial health problems, which may increase their risk for HIV infection. Few studies have explored the syndemic effect of co-occurring psychosocial health problems on HIV sexual risk among Nigerian GBMSM. We investigated the co-occurrence of syndemic psychosocial health problems and their synergistic effect on HIV risk behaviors. We assessed depressive symptoms, post-traumatic stress disorder, alcohol dependence, tobacco use, and hard-drug use. The outcome variables were the number of male sexual partners and consistent condom use. In a multivariable model, experiencing 4 or more psychosocial health problems – compared to experience none or one psychosocial health problem – was significantly associated with increasing number of male sexual partners. We found no statistically significant association between the number of syndemic psychosocial health problems and consistent condom use. Our study findings provides evidence of a synergistic relationship between negative psychosocial health factors and HIV sexual risk behavior. These findings underscore the importance of developing HIV prevention programming aimed at reducing HIV transmission risk that incorporate substance use and mental health treatments, in order to improve the overall health and quality of life for Nigerian GBMSM.

KEYWORDS:

• Nigeria
• GBMSM
• syndemics
• psychosocial health problems
• HIV sexual risk
• Africa
• mental health
• substance use

Acknowledgments

We will like to thank all the participants of the study as this study and manuscript will not be possible without their participation. We will also like to thank our in-country collaborators, Centre for Right to Health and Equality Triangle Initiative.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Katie B. Biello http://orcid.org/0000-0002-5017-5699

Matthew J. Mimiaga http://orcid.org/0000-0001-9256-2905

Additional information

Funding

This study was supported by a grant from Brown University Global Health Initiative. Additionally, this research was supported, in part, by the National Institute on Drug Abuse [DA047216] (principal investigator [PI]: Adedotun Ogunbajo, PhD (c)), the National Institute of Mental Health under [R25MH083620] [PI]: Amy Nunn, PhD) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development [P2CHD041020] (PI: Susan Short, PhD), for which the first author is a trainee but did not support project-specific expenses. This work was also supported by the Robert Wood Johnson Foundation Health Policy Research Scholars Program, for which the first author is a scholar but did not support project-specific expenses.