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Using data from a broader ethnographic study of HIV epidemics in the Kansai Region and Tokyo Metropolitan Area of Japan, I found that HIV was synergistically linked with poor mental health, substance use, and violence, suggesting the existence of at least three syndemics. These occurred in an environment of stigma and social and health disparities, particularly for men who have sex with men, transgender persons, immigrants, and people living with HIV. Integrated interventions, led by Japan\u2019s HIV nongovernmental organizations and supported by the government, should more aggressively target stigma, which underlies most of the syndemic connections. Quantitative research should build upon the ethnographically derived associations shown here and test whether there are additive syndemic effects.<\/jats:p>","DOI":"10.1177\/1049732315627644","type":"journal-article","created":{"date-parts":[[2016,2,4]],"date-time":"2016-02-04T21:29:47Z","timestamp":1454621387000},"page":"877-894","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["HIV\u2019s Syndemic Links With Mental Health, Substance Use, and Violence in an Environment of Stigma and Disparities in Japan"],"prefix":"10.1177","volume":"26","author":[{"given":"Anthony S.","family":"DiStefano","sequence":"first","affiliation":[{"name":"California State University, Fullerton, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,2,4]]},"reference":[{"key":"bibr1-1049732315627644","volume-title":"Association for Asian Studies Annual Conference","author":"Arlington C.","year":"2015"},{"key":"bibr2-1049732315627644","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000658"},{"key":"bibr3-1049732315627644","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-015-9750-y"},{"key":"bibr4-1049732315627644","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0925-6"},{"key":"bibr5-1049732315627644","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030452"},{"key":"bibr6-1049732315627644","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300433"},{"key":"bibr7-1049732315627644","doi-asserted-by":"publisher","DOI":"10.2307\/1127743"},{"key":"bibr8-1049732315627644","unstructured":"Centers for Disease Control and Prevention. 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