{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:53:36Z","timestamp":1785524016756,"version":"3.56.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Syndemic models have been used in previous studies exploring HIV-related outcomes; however, these models do not fully consider intersecting psychosocial (\n                      <jats:italic toggle=\"yes\">e.g.<\/jats:italic>\n                      , substance use, depressive symptoms) and structural factors (unstable housing, concentrated housing vacancy) that influence the lived experiences of women. Therefore, there is a need to explore the syndemic effects of psychosocial and structural factors on HIV risk behaviors to better explain the multilevel factors shaping HIV disparities among black women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This analysis uses baseline data (May 2009\u2013August 2010) from non-Hispanic black women enrolled in the HIV Prevention Trials Network 064 Women\u2019s Seroincidence Study (HPTN 064) and the American Community Survey 5-year estimates from 2007 to 2011. Three parameterizations of syndemic factors were applied in this analysis a cumulative syndemic index, three syndemic groups reflecting the level of influence (psychosocial syndemic group, participant-level structural syndemic group, and a neighborhood-level structural syndemic group), and syndemic factor groups. Clustered mixed effects log-binomial analyses measured the relationship of each syndemic parameterization on HIV risk behaviors in 1,347 black women enrolled in HPTN 064.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A higher syndemic score was significantly associated with increased prevalence of unknown HIV status of the last male sex partner (adjusted prevalence ratio (aPR) = 1.07, 95% confidence interval or CI 1.04\u20131.10), involvement in exchange sex (aPR = 1.17, 95% CI: 1.14\u20131.20), and multiple sex partners (aPR = 1.07, 95% CI: 1.06\u20131.09) in the last 6 months. A dose\u2013response relationship was observed between the number of syndemic groups and HIV risk behaviors, therefore, being in multiple syndemic groups was significantly associated with increased prevalence of reporting HIV risk behaviors compared with being in one syndemic group. In addition, being in all three syndemic groups was associated with increased prevalence of unknown HIV status of the last male sex partner (aPR = 1.67, 95% CI: 1.43\u20131.95) and multiple sex partners (aPR = 1.53, 95% CI: 1.36\u20131.72).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Findings highlight syndemic factors influence the lived experiences of black women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2023.0458","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T04:58:40Z","timestamp":1710824320000},"page":"816-826","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring Psychosocial and Structural Syndemic Effects as Predictors of HIV Risk Behaviors Among Black Women (HPTN 064)"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2803-6801","authenticated-orcid":false,"given":"Lakeshia","family":"Watson","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Haley","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodman","family":"Turpin","sequence":"additional","affiliation":[{"name":"Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianzhou","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh C.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Typhanye","family":"Dyer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the HPTN 064 Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Centers for Disease Control and Prevention (CDC). NCHHSTP AtlasPlus. Atlanta GA; 2022. Available from: https:\/\/www.cdc.gov\/nchhstp\/atlas\/ [Last accessed: November7 2023]."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2328"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-015-9944-5"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1224296"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1134-7"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-021-03448-w"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2006.01.015"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1320"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0439-7"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.90.4.560"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1023\/a:1025447820399"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0749-3797(99)00084-7"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)30158-2"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1015494513192"},{"key":"e_1_3_5_16_2","unstructured":"Centers for Disease Control and Prevention. Social determinants of health among adults with diagnosed HIV infection in the United States and Puerto Rico 2021. HIV Surveillance Supplemental Report 2023;28(5); 2023. Available from: http:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html [Last accessed: October 2023]."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-1-201301010-00004"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2013.25.3.203"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1525\/maq.2003.17.4.423"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2006.05.012"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90205-4"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000634"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2014.0278"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-013-9797-8"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0027-9684(15)30639-8"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/1524838007301476"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2015.0328"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2020.0033"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000657"},{"key":"e_1_3_5_30_2","unstructured":"The HIV Prevention Trials Network [Internet]. Available from: https:\/\/www.hptn.org\/research\/studies\/hptn064 [Last accessed: October29 2023]."},{"issue":"4","key":"e_1_3_5_31_2","first-page":"213","article-title":"Street and network sampling in evaluation studies of HIV risk-reduction interventions","volume":"4","author":"Semaan S","year":"2002","unstructured":"Semaan S, , Lauby J, , Liebman J. Street and network sampling in evaluation studies of HIV risk-reduction interventions. AIDS Rev, 2002; 4(4):213\u2013223.","journal-title":"AIDS Rev"},{"key":"e_1_3_5_32_2","unstructured":"U.S. Census Bureau. American Community Survey Information Guide. Washington DC; 2017. Available from: https:\/\/www.census.gov\/content\/dam\/Census\/programs-surveys\/acs\/about\/ACS_Information_Guide.pdf [Last accessed: October29 2023]."},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.5.e85"},{"issue":"1","key":"e_1_3_5_35_2","first-page":"9","article-title":"The primary care PTSD screen (PC-PTSD): development and operating characteristics","volume":"9","author":"Cameron RP","year":"2003","unstructured":"Cameron RP, , Gusman D. The primary care PTSD screen (PC-PTSD): development and operating characteristics. Primary Care Psychiatry, 2003; 9(1):9\u201314.","journal-title":"Primary Care Psychiatry"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02611-8"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2013.0366"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2016.0093"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00185.x"},{"key":"e_1_3_5_40_2","unstructured":"Fernald M. America\u2019s rental housing: Evolving markets and needs. Joint Center for Housing Studies of Harvard University Cambridge MA. 2013. Available from: https:\/\/www.jchs.harvard.edu\/sites\/default\/files\/jchs_americas_rental_housing_2013_1_0.pdf"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2016.09.004"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0884-y"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-9911-4"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002009"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2051-3"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000186364.27587.0e"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.03.004"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.06.033"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2100-y"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2023.0458","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2023.0458","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2023.0458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:59:34Z","timestamp":1777658374000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/jwh.2023.0458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":48,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1089\/jwh.2023.0458"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2023.0458","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]}}}