TY - JOUR
T1 - Connecting the dots
T2 - a comparison of network analysis and exploratory factor analysis to examine psychosocial syndemic indicators among HIV-negative sexual minority men
AU - Lee, J. S.
AU - Bainter, S. A.
AU - Carrico, A. W.
AU - Glynn, T. R.
AU - Rogers, B. G.
AU - Albright, C.
AU - O’Cleirigh, C.
AU - Mayer, K. H.
AU - Safren, S. A.
N1 - Funding Information:
The project described was supported by P01AI074415 (Altfeld), an unrestricted research grant from Alere, Harvard University Center for AIDS Research 5P30AI060354. Some of the author time was supported by 9K24DA040489 and 1P30MH116867 (Safren). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Drug Abuse, National Institute of Allergy and Infectious Diseases, the National Institutes of Health, or any of the other funders.
PY - 2020/12
Y1 - 2020/12
N2 - Syndemics, or comorbid and mutually reinforcing psychosocial problems, are associated with increased HIV risk among men who have sex with men (MSM). Although the dynamic interplay among syndemic indicators is theorized to be crucial for increasing risk of HIV acquisition, novel approaches are needed to understand how these syndemic problems interrelate. This study examined the associations between nine self-reported syndemic indicators in 194 MSM at high risk of HIV acquisition. We compared exploratory factor analyses (EFA) to a network analysis. In the present study, network analysis consisted of edges representing bidirectional partial polychoric correlations between nodes, which represent psychosocial syndemic indicators. EFA yielded a 1-factor solution including suicidal ideation (SI), injection drug use (IDU), depression, social anxiety, intimate partner violence, substance use, and sexual compulsivity, and excluded heavy drinking and childhood sexual abuse. Network analysis yielded a pattern of interconnectedness with the most central nodes being SI, IDU, substance use, and depression. Statistically significant relationships (absolute edge weights) were found between SI and depression, social anxiety, and IDU, and IDU and substance use. These results suggest that depression and substance use, especially more severe presentations of these conditions such as SI and IDU, are prominent interconnected components of the HIV syndemic among MSM at high risk for HIV acquisition. SI, IDU, substance use, and depression may indeed be prudent targets of intervention. Future research on the inclusion of these syndemic indicators in analytical models involving interaction terms may be warranted.
AB - Syndemics, or comorbid and mutually reinforcing psychosocial problems, are associated with increased HIV risk among men who have sex with men (MSM). Although the dynamic interplay among syndemic indicators is theorized to be crucial for increasing risk of HIV acquisition, novel approaches are needed to understand how these syndemic problems interrelate. This study examined the associations between nine self-reported syndemic indicators in 194 MSM at high risk of HIV acquisition. We compared exploratory factor analyses (EFA) to a network analysis. In the present study, network analysis consisted of edges representing bidirectional partial polychoric correlations between nodes, which represent psychosocial syndemic indicators. EFA yielded a 1-factor solution including suicidal ideation (SI), injection drug use (IDU), depression, social anxiety, intimate partner violence, substance use, and sexual compulsivity, and excluded heavy drinking and childhood sexual abuse. Network analysis yielded a pattern of interconnectedness with the most central nodes being SI, IDU, substance use, and depression. Statistically significant relationships (absolute edge weights) were found between SI and depression, social anxiety, and IDU, and IDU and substance use. These results suggest that depression and substance use, especially more severe presentations of these conditions such as SI and IDU, are prominent interconnected components of the HIV syndemic among MSM at high risk for HIV acquisition. SI, IDU, substance use, and depression may indeed be prudent targets of intervention. Future research on the inclusion of these syndemic indicators in analytical models involving interaction terms may be warranted.
KW - Exploratory factor analysis
KW - HIV
KW - Men who have sex with men
KW - Network analysis
KW - Syndemics
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U2 - 10.1007/s10865-020-00148-z
DO - 10.1007/s10865-020-00148-z
M3 - Article
C2 - 32361793
AN - SCOPUS:85085135610
VL - 43
SP - 1026
EP - 1040
JO - Journal of Behavioral Medicine
JF - Journal of Behavioral Medicine
SN - 0160-7715
IS - 6
ER -