Spiraling Risk: Visualizing the multilevel factors that socially pattern HIV risk among gay, bisexual & other men who have sex with men using Complex Systems Theory.

IF 3.7 2区 医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2023-08-01 DOI:10.1007/s11904-023-00664-y
K Stojanovski, E J King, S O'Connell, K S Gallagher, K P Theall, A T Geronimus
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Abstract

Purpose of review: Global disparities in HIV infection, particularly among gay, bisexual, and other men who have sex with men (GBMSM), indicate the importance of exploring the multi-level processes that shape HIV's spread. We used Complex Systems Theory and the PRISMA guidelines to conduct a systematic review of 63 global reviews to understand how HIV is socially patterned among GBMSM. The purpose was to conduct a thematic analysis of the reviews to (1) synthesize the multi-level risk factors of HIV risk, (2) categorize risk across the socioecological model, and (3) develop a conceptual model that visualizes the interrelated factors that shape GBMSMS's HIV "risk."

Recent findings: We included 49 studies of high and moderate quality studies. Results indicated that GBMSM's HIV risk stems from the individual, interpersonal, and structural levels of the socioecological model. We identified a few themes that shape GBMSM's risk of HIV infection related to biomedical prevention methods; sexual and sex-seeking behaviors; behavioral prevention methods; individual-level characteristics and syndemic infections; lived experiences and interpersonal relationships; country-level income; country-level HIV prevalence; and structural stigma. The multi-level factors, in tandem, serve to perpetuate GBMSM's risk of HIV infection globally. The amalgamation of our thematic analyses from our systematic reviews of reviews suggests that the risk of HIV infection operates in an emergent, dynamic, and complex nature across multiple levels of the socioecological model. Applying complex systems theory indicates how multilevel factors create a dynamic and reinforcing system of HIV risk among GBMSM.

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螺旋式风险:利用复杂系统理论可视化在同性恋、双性恋和其他男男性行为者中社会模式HIV风险的多层次因素。
综述目的:艾滋病毒感染的全球差异,特别是同性恋、双性恋和其他男男性行为者(GBMSM)之间的差异,表明探索影响艾滋病毒传播的多层次过程的重要性。我们使用复杂系统理论和PRISMA指南对63项全球综述进行了系统综述,以了解HIV在GBMSM中的社会模式。目的是对综述进行专题分析,以(1)综合艾滋病毒风险的多层次风险因素,(2)跨社会生态模型对风险进行分类,(3)建立一个概念性模型,将影响GBMSMS艾滋病毒风险的相关因素可视化。“最近的发现:我们纳入了49项高质量和中等质量的研究。结果表明,GBMSM的HIV风险来自社会生态模型的个体、人际和结构层面。我们确定了几个与生物医学预防方法有关的影响GBMSM感染艾滋病毒风险的主题;性和寻求性的行为;行为预防方法;个体水平特征与合并症感染;生活经历和人际关系;国家层面的收入;国家一级的艾滋病毒流行情况;以及结构性的病耻感。这些多层次的因素串联在一起,使gbsm在全球范围内感染艾滋病毒的风险持续存在。我们对综述的系统综述的主题分析的合并表明,艾滋病毒感染的风险在社会生态模型的多个层面上以一种紧急的、动态的和复杂的性质运作。运用复杂系统理论揭示了多重因素如何形成一个动态强化的GBMSM HIV风险系统。
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来源期刊
Current HIV/AIDS Reports
Current HIV/AIDS Reports INFECTIOUS DISEASES-
CiteScore
8.10
自引率
2.20%
发文量
45
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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