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Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV

Author

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  • Emmanuel Peprah

    (Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA)

  • Elisabet Caler

    (Office of AIDS Research, National Institutes of Health, Bethesda, MD 20852 USA)

  • Anya Snyder

    (Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA)

  • Fassil Ketema

    (National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA)

Abstract

The HIV epidemic has dramatically changed over the past 30 years; there are now fewer newly infected people (especially children), fewer AIDS-related deaths, and more people with HIV (PWH) receiving treatment. However, the HIV epidemic is far from over. Despite the tremendous advances in anti-retroviral therapies (ART) and the implementation of ART regimens, HIV incidence (number of new infections over a defined period of time) and prevalence (the burden of HIV infection) in certain regions of the world and socio-economic groups are still on the rise. HIV continues to disproportionally affect highly marginalized populations that constitute higher-risk and stigmatized groups, underserved and/or neglected populations. In addition, it is not uncommon for PWH to suffer enhanced debilitating conditions resulting from the synergistic interactions of both communicable diseases (CDs) and non-communicable diseases (NCDs). While research utilizing only a comorbidities framework has advanced our understanding of the biological settings of the co-occurring conditions from a molecular and mechanistic view, harmful interactions between comorbidities are often overlooked, particularly under adverse socio-economical and behavioral circumstances, likely prompting disease clustering in PWH. Synergistic epidemics (syndemics) research aims to capture these understudied interactions: the mainly non-biological aspects that are central to interpret disease clustering in the comorbidities/multi-morbidities only framework. Connecting population-level clustering of social and health problems through syndemic interventions has proved to be a critical knowledge gap that will need to be addressed in order to improve prevention and care strategies and bring us a step closer to ending the HIV epidemic.

Suggested Citation

  • Emmanuel Peprah & Elisabet Caler & Anya Snyder & Fassil Ketema, 2020. "Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV," IJERPH, MDPI, vol. 17(13), pages 1-7, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:13:p:4704-:d:378350
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    References listed on IDEAS

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    1. Randolph C. H. Chan & Don Operario & Winnie W. S. Mak, 2020. "Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV," IJERPH, MDPI, vol. 17(6), pages 1-15, March.
    2. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    Cited by:

    1. Emmanuel Peprah & Mari Armstrong-Hough & Stephanie H. Cook & Barbara Mukasa & Jacquelyn Y. Taylor & Huichun Xu & Linda Chang & Joyce Gyamfi & Nessa Ryan & Temitope Ojo & Anya Snyder & Juliet Iwelunmor, 2021. "An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa," IJERPH, MDPI, vol. 18(6), pages 1-12, March.

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