Syndemics, or comorbid and mutually reinforcing psychosocial problems, are associated with increased HIV risk among men who have sex with men (MSM). Although the dynamic interplay among syndemic indicators is theorized to be crucial for increasing risk of HIV acquisition, novel approaches are needed to understand how these syndemic problems interrelate. This study examined the associations between nine self-reported syndemic indicators in 194 MSM at high risk of HIV acquisition. We compared exploratory factor analyses (EFA) to a network analysis. In the present study, network analysis consisted of edges representing bidirectional partial polychoric correlations between nodes, which represent psychosocial syndemic indicators. EFA yielded a 1-factor solution including suicidal ideation (SI), injection drug use (IDU), depression, social anxiety, intimate partner violence, substance use, and sexual compulsivity, and excluded heavy drinking and childhood sexual abuse. Network analysis yielded a pattern of interconnectedness with the most central nodes being SI, IDU, substance use, and depression. Statistically significant relationships (absolute edge weights) were found between SI and depression, social anxiety, and IDU, and IDU and substance use. These results suggest that depression and substance use, especially more severe presentations of these conditions such as SI and IDU, are prominent interconnected components of the HIV syndemic among MSM at high risk for HIV acquisition. SI, IDU, substance use, and depression may indeed be prudent targets of intervention. Future research on the inclusion of these syndemic indicators in analytical models involving interaction terms may be warranted.

中文翻译：

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点点滴滴：网络分析和探索性因素分析的比较，以检查 HIV 阴性性少数男性的心理社会综合指标。

综合征，或共病和相辅相成的社会心理问题，与男男性行为者 (MSM) 的 HIV 风险增加有关。尽管从理论上讲，综合指标之间的动态相互作用对于增加感染 HIV 的风险至关重要，但仍需要新的方法来了解这些综合问题之间的相互关系。本研究检查了 194 名处于 HIV 感染高风险的 MSM 中九个自我报告的症状指标之间的关联。我们将探索性因素分析 (EFA) 与网络分析进行了比较。在本研究中，网络分析由代表节点之间的双向部分多元相关性的边组成，这些边代表了社会心理综合指标。EFA 产生了一个单因素解决方案，包括自杀意念 (SI)、注射吸毒 (IDU)、抑郁、社交焦虑、亲密伴侣暴力、药物使用和性强迫，并排除酗酒和儿童期性虐待。网络分析产生了一种相互关联的模式，最核心的节点是 SI、IDU、物质使用和抑郁症。在 SI 和抑郁、社交焦虑和 IDU 以及 IDU 和物质使用之间发现了统计学上显着的关系（绝对边缘权重）。这些结果表明，抑郁症和物质使用，尤其是这些疾病的更严重表现，如 SI 和 IDU，是 HIV 感染高风险 MSM 中 HIV 综合征的突出相互关联的组成部分。SI、IDU、药物滥用和抑郁症可能确实是谨慎的干预目标。