The theory of syndemics has been widely applied in HIV prevention studies of gay, bisexual, and other MSM over the last decade. Our investigation is the first to consider the applicability of the theory in a sample of aging (ages 50 and over) HIV-positive MSM, which is a growing population in the United States. A sample of 199 men were actively recruited and assessed in terms of mental health and drug use burden, as well as sexual risk behaviors. Bivariate and multivariable analyses indicate a high level of association between psychosocial burdens (i.e., drug use and mental health) and same-sex unprotected sexual behaviors, providing initial support for the applicability of the theory of syndemics to this population. Further support can be seen in participants' narratives. Findings suggest the mutually reinforcing nature of drug use, psychiatric disorders, and unprotected sexual behavior in older, HIV-positive, gay, bisexual, and other MSM, highlighting the need for holistic strategies to prevention and care among this population of older and sexually active individuals. In short, the generation of gay men who came of age in the late 1970s and 1980s, "the AIDS Generation," are continuing to mature such that further efforts must be enacted to meet the multidimensional nature of these men's physical, mental, and sexual health needs.

中文翻译：

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老年 HIV 阳性男同性恋、双性恋和其他 MSM 的综合证据：对预防和医疗保健整体方法的影响。

在过去十年中，综合征理论已广泛应用于同性恋、双性恋和其他 MSM 的 HIV 预防研究。我们的调查首次考虑了该理论在老龄化（50 岁及以上）HIV 阳性 MSM 样本中的适用性，该样本在美国人口不断增长。积极招募了 199 名男性样本，并在心理健康和吸毒负担以及性风险行为方面进行了评估。双变量和多变量分析表明社会心理负担（即吸毒和心理健康）与同性无保护性行为之间存在高度关联，这为综合征理论对这一人群的适用性提供了初步支持。在参与者的叙述中可以看到进一步的支持。调查结果表明吸毒的相互加强性质，精神疾病，以及老年人、HIV 阳性、男同性恋、双性恋和其他 MSM 中无保护的性行为，突出表明需要在这些老年人和性活跃人群中采取整体策略来预防和护理。简而言之，在 1970 年代末和 1980 年代成年的这一代男同性恋者，即“艾滋病一代”正在继续成熟，因此必须做出进一步的努力来满足这些男性身体、心理和性方面的多维本质。健康需要。