Longitudinal Analysis of Overlapping Psychosocial Factors Predicting Incident Hospitalization Among Mixed HIV Serostatus Men who have Sex with Men in the Multicenter AIDS Cohort Study.
Yuhang Qian, Roger Detels, Warren Scott Comulada, Marco A Hidalgo, Sung-Jae Lee, Katie B Biello, Elizabeth A Yonko, M Reuel Friedman, Frank J Palella, Michael W Plankey, Matthew J Mimiaga
Author Information
Yuhang Qian: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA. yuhang886688@g.ucla.edu. ORCID
Roger Detels: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Warren Scott Comulada: Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
Marco A Hidalgo: Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
Sung-Jae Lee: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Katie B Biello: Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.
Elizabeth A Yonko: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
M Reuel Friedman: School of Public Health, Newark, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Frank J Palella: Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Michael W Plankey: Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA.
Matthew J Mimiaga: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Men who have sex with men (MSM) are at increased risk for certain types of chronic diseases and mental health problems. Despite having extended survival in the highly active antiretroviral therapy (HAART) era, MSM living with HIV contend with aging-related diseases and complications with treatment. Consequent hospitalizations incur high costs, fear, low quality of life, and frailty. Unlike heterosexual men, MSM experience more structural violence and "syndemics" of psychosocial factors that not only accelerate HIV acquisition and transmission risk but also may increase morbidity, leading to greater rates of hospitalization. We aim to examine the impact of "syndemic" psychosocial factors on the incidence of hospitalization among geographically diverse MSM in the US. Participants were 1760 MSM from the Multicenter AIDS Cohort Study (MACS) between 2004 and 2019. We examined the relationship between six psychosocial factors (depression, stimulant use, smoking, heroin use, childhood sexual abuse, and intimate partner violence) and incident hospitalization (admission to a hospital for treatment). We found a positive dose-response relationship between the number of syndemic factors and hospitalization. MSM reporting five or more syndemic factors had over twice the risk of hospitalization compared to MSM without syndemic factors [aRR = 2.14 (95% CI = 1.56, 2.94)]. Psychosocial factors synergistically increased hospitalizations over time. The positive dose-response relationship between the number of syndemic factors and hospitalization and the synergistic effects of these factors underscore the need for interventions that disentangle the syndemics to reduce hospitalization and related costs and improve the quality of life among MSM.
