Longitudinal Effects of Syndemics on ART Non-adherence Among Sexual Minority Men

Audrey Harkness, Sierra A. Bainter, Conall O’Cleirigh, Noelle A. Mendez, Kenneth H. Mayer, Steven A. Safren

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


This study examined longitudinally the additive effect of syndemics, or co-occurring psychosocial problems, on antiretroviral treatment (ART) non-adherence among 390 HIV-positive sexual minority men. Participants completed measures of ART adherence (reduced to a non-adherence score using exploratory factor analysis) and six syndemic conditions. We employed multilevel modeling with the number of syndemics as a longitudinal predictor of non-adherence, and logistic regression with baseline syndemics predicting follow up viral load. Number of syndemics was a significant longitudinal predictor of non-adherence, with each additional syndemic associated with a 0.13 increase in non-adherence (p = 0.004). Each additional syndemic was also associated with 1.27 greater odds of detectable viral load (p = 0.002). Among HIV-positive sexual minority men in this sample, more syndemics were associated with lower ART adherence and greater odds of detectable viral load, suggesting the need for behavioral intervention to facilitate care for this population.

Original languageEnglish (US)
Pages (from-to)2564-2574
Number of pages11
JournalAIDS and Behavior
Issue number8
StatePublished - Aug 1 2018


  • Adherence
  • Antiretroviral therapy/ART
  • HIV
  • Sexual minority
  • Syndemics

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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