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Open AccessArticle

Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV

1
Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
2
Office of AIDS Research, National Institutes of Health, Bethesda, MD 20852 USA
3
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(13), 4704; https://doi.org/10.3390/ijerph17134704
Received: 24 April 2020 / Revised: 19 June 2020 / Accepted: 23 June 2020 / Published: 30 June 2020
(This article belongs to the Special Issue Global Economic Burden of HIV/AIDS)
The HIV epidemic has dramatically changed over the past 30 years; there are now fewer newly infected people (especially children), fewer AIDS-related deaths, and more people with HIV (PWH) receiving treatment. However, the HIV epidemic is far from over. Despite the tremendous advances in anti-retroviral therapies (ART) and the implementation of ART regimens, HIV incidence (number of new infections over a defined period of time) and prevalence (the burden of HIV infection) in certain regions of the world and socio-economic groups are still on the rise. HIV continues to disproportionally affect highly marginalized populations that constitute higher-risk and stigmatized groups, underserved and/or neglected populations. In addition, it is not uncommon for PWH to suffer enhanced debilitating conditions resulting from the synergistic interactions of both communicable diseases (CDs) and non-communicable diseases (NCDs). While research utilizing only a comorbidities framework has advanced our understanding of the biological settings of the co-occurring conditions from a molecular and mechanistic view, harmful interactions between comorbidities are often overlooked, particularly under adverse socio-economical and behavioral circumstances, likely prompting disease clustering in PWH. Synergistic epidemics (syndemics) research aims to capture these understudied interactions: the mainly non-biological aspects that are central to interpret disease clustering in the comorbidities/multi-morbidities only framework. Connecting population-level clustering of social and health problems through syndemic interventions has proved to be a critical knowledge gap that will need to be addressed in order to improve prevention and care strategies and bring us a step closer to ending the HIV epidemic. View Full-Text
Keywords: HIV; Syndemics; non-communicable diseases; public health; communicable diseases; cardiovascular disease; lung diseases; low and middle-income countries; sleep disorder; health disparity; comorbidity HIV; Syndemics; non-communicable diseases; public health; communicable diseases; cardiovascular disease; lung diseases; low and middle-income countries; sleep disorder; health disparity; comorbidity
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Peprah, E.; Caler, E.; Snyder, A.; Ketema, F. Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV. Int. J. Environ. Res. Public Health 2020, 17, 4704.

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