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

Emmanuel Peprah, Elisabet Caler, Anya Snyder and Fassil Ketema
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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

IJERPH, 2020, vol. 17, issue 13, 1-7

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.

Keywords: HIV; Syndemics; non-communicable diseases; public health; communicable diseases; cardiovascular disease; lung diseases; low and middle-income countries; sleep disorder; health disparity; comorbidity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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