{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:25:54Z","timestamp":1790162754531,"version":"4.1.0"},"reference-count":56,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:00:00Z","timestamp":1539043200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:00:00Z","timestamp":1539043200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["J. Biosoc. Sci."],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tuberculosis (TB) remains a major global public health problem that has become a crisis fuelled by HIV and the increasing occurrence of antimicrobial resistance. What has been termed the biosocial nature of TB challenges effective control of the disease. Yet, biosocial interactions involved in the persistence of TB in diverse settings are difficult to systematically account for. The recently developed framework of syndemics provides a way to capture how complex health problems result from the interactions between diseases such as HIV and TB, and harmful social conditions such as unemployment, malnutrition and substance abuse. This article advances the syndemics scholarship by examining health conditions that cluster together with TB in the Russian Federation, by eliciting a set of social processes that precipitate this clustering and exacerbate health outcomes, and by analysing interactions between these health conditions and social processes. To provide an account of this complexity, the article takes a qualitative approach and draws on the perspectives and experiences of people with TB. The results demonstrate emergence of a syndemic of stress, substance abuse, TB and HIV that is sustained by poverty, occupational insecurity, marginalization and isolation. Frictions between the narrow focus of the health care system on TB and the wider syndemic processes in which the lives of many persons with TB are embedded, contribute to poorer health outcomes and increase the risks of developing drug resistance. Finally, the article argues that the large-scale and impersonal forces become embodied as individual pathology through the crucial interface of the ways in which persons experience and make sense of these forces and pathologies. Qualitative research is needed for the adequate analysis of this biosocial complexity in order to provide a solid basis for responses to TB-centred syndemics in various settings.<\/jats:p>","DOI":"10.1017\/s0021932018000263","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T08:41:26Z","timestamp":1539074486000},"page":"403-417","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["EXPERIENCING SYNDEMIC: DISENTANGLING THE BIOSOCIAL COMPLEXITY OF TUBERCULOSIS THROUGH QUALITATIVE RESEARCH"],"prefix":"10.1017","volume":"51","author":[{"given":"Olga","family":"Zvonareva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willemien","family":"van Bergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadezhda","family":"Kabanets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Alliluyev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Filinyuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"S0021932018000263_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70030-6"},{"key":"S0021932018000263_ref41","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-450"},{"key":"S0021932018000263_ref48","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30003-X"},{"key":"S0021932018000263_ref11","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"S0021932018000263_ref51","doi-asserted-by":"publisher","DOI":"10.1093\/med:psych\/9780198568841.001.0001"},{"key":"S0021932018000263_ref44","volume-title":"Equity, Social Determinants and Public Health Programmes","author":"Schmidt","year":"2010"},{"key":"S0021932018000263_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01738.x"},{"key":"S0021932018000263_ref42","volume-title":"Narrative Methods for the Human Sciences","author":"Riessman","year":"2008"},{"key":"S0021932018000263_ref18","volume-title":"Pathologies of Power: Health, Human Rights, and the New War on the Poor","author":"Farmer","year":"2003"},{"key":"S0021932018000263_ref3","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2009.0211"},{"key":"S0021932018000263_ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2005.04.001"},{"key":"S0021932018000263_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932016000626"},{"key":"S0021932018000263_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.2006.00097.x"},{"key":"S0021932018000263_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780198297413.001.0001"},{"key":"S0021932018000263_ref15","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00136004"},{"key":"S0021932018000263_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30403-8"},{"key":"S0021932018000263_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.03.041"},{"key":"S0021932018000263_ref52","doi-asserted-by":"publisher","DOI":"10.1111\/maq.12335"},{"key":"S0021932018000263_ref6","volume-title":"Transforming Qualitative Information: Thematic Analysis and Code Development","author":"Boyatzis","year":"1998"},{"key":"S0021932018000263_ref14","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.01126-10"},{"key":"S0021932018000263_ref23","doi-asserted-by":"publisher","DOI":"10.1038\/nri1571"},{"key":"S0021932018000263_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60410-2"},{"key":"S0021932018000263_ref56","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30261-1"},{"key":"S0021932018000263_ref35","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.045732"},{"key":"S0021932018000263_ref24","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1425.009"},{"key":"S0021932018000263_ref19","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1183\/09031936.05.00136004","article-title":"Tuberculosis, HIV seroprevalence and intravenous drug abuse in prisoners","volume":"26","author":"Fedorin","year":"2005","journal-title":"European Respiratory Journal"},{"key":"S0021932018000263_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.06.014"},{"key":"S0021932018000263_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(00)00096-4"},{"key":"S0021932018000263_ref5","doi-asserted-by":"publisher","DOI":"10.1057\/palgrave.jphp.3200002"},{"key":"S0021932018000263_ref8","volume-title":"Health and Social Change in Russia and Eastern Europe","author":"Cockerham","year":"1999"},{"key":"S0021932018000263_ref9","doi-asserted-by":"publisher","DOI":"10.1126\/science.aal1167"},{"key":"S0021932018000263_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2010.00202.x"},{"key":"S0021932018000263_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(96)00143-8"},{"key":"S0021932018000263_ref17","volume-title":"Infections and Inequalities: The Modern Plagues","author":"Farmer","year":"1999"},{"key":"S0021932018000263_ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp048066"},{"key":"S0021932018000263_ref25","first-page":"559","article-title":"\u201cIt is easier for me to shoot up\u201d: stigma, abandonment, and why HIV-positive drug users in Russia fail to link to HIV care","volume":"29","author":"Kiriazova","year":"2017","journal-title":"AIDS Care\u2013Psychological and Socio-Medical Aspects of AIDS\/HIV"},{"key":"S0021932018000263_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-8-289"},{"key":"S0021932018000263_ref28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801153380307"},{"key":"S0021932018000263_ref29","doi-asserted-by":"publisher","DOI":"10.1111\/maq.12277"},{"key":"S0021932018000263_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932015000115"},{"key":"S0021932018000263_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.14.1685"},{"key":"S0021932018000263_ref54","unstructured":"WHO (2017) Global Tuberculosis Report 2017. WHO, Geneva."},{"key":"S0021932018000263_ref32","doi-asserted-by":"publisher","DOI":"10.1086\/651475"},{"key":"S0021932018000263_ref39","first-page":"1097","article-title":"Tuberculosis in Russia","volume":"4","author":"Perelman","year":"2000","journal-title":"International Journal of Tuberculosis and Lung Disease"},{"key":"S0021932018000263_ref46","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932016000638"},{"key":"S0021932018000263_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/maq.12215"},{"key":"S0021932018000263_ref34","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.11.0795"},{"key":"S0021932018000263_ref36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00262.x"},{"key":"S0021932018000263_ref37","volume-title":"Global Health: Why Cultural Perceptions, Social Representations, and Biopolitics Matter","author":"Nichter","year":"2008"},{"key":"S0021932018000263_ref40","first-page":"1","article-title":"Russian Federation\u2013Health system review","volume":"13","author":"Popovich","year":"2011","journal-title":"Health Systems in Transition"},{"key":"S0021932018000263_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00218-0"},{"key":"S0021932018000263_ref45","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932016000614"},{"key":"S0021932018000263_ref47","first-page":"99","article-title":"A dose of drugs, a touch of violence, a case of AIDS: conceptualizing the Sava syndemic","volume":"24","author":"Singer","year":"1996","journal-title":"Free Inquiry in Creative Sociology"},{"key":"S0021932018000263_ref53","unstructured":"WHO (2014) Global Status Report on Alcohol and Health. WHO, Geneva."},{"key":"S0021932018000263_ref55","unstructured":"WHO Regional Office for Europe (2016) European \u201cHealth for All\u201d Database (HFA-DB). URL: http:\/\/data.euro.who.int\/hfadb\/ (accessed 1st December 2017)."},{"key":"S0021932018000263_ref38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002464"}],"container-title":["Journal of Biosocial Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0021932018000263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T23:38:56Z","timestamp":1555025936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0021932018000263\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,9]]},"references-count":56,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["S0021932018000263"],"URL":"https:\/\/doi.org\/10.1017\/s0021932018000263","relation":{},"ISSN":["0021-9320","1469-7599"],"issn-type":[{"value":"0021-9320","type":"print"},{"value":"1469-7599","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,9]]},"assertion":[{"value":"\u00a9 Cambridge University Press, 2018.\u00a0This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}