Integrative Review of Methods From Youth Risk Behavior Survey Secondary Data Analyses Examining HIV Syndemic Factors Among Adolescent Gay and Bisexual Men. 2023

David Ray Garcia, and Jason Fletcher, and Lloyd Goldsamt, and Ann-Margaret Dunn Navarra

Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos.

UI MeSH Term Description Entries
D008297 Male Males
D005260 Female Females
D005783 Gender Identity A person's concept of self as being male and masculine or female and feminine, or ambivalent, based in part on physical characteristics, parental responses, and psychological and social pressures. It is the internal experience of gender role. Gender,Gender Identities,Identity, Gender
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072339 Sexual and Gender Minorities Individuals including lesbian, gay, bisexual, transgender, queer, intersex, gender non-conforming people, and other populations whose sexual orientation or GENDER IDENTITY and reproductive development is considered outside cultural, societal, or physiological norms. Gays,Gender Diverse,LGBTQ,LGBTQIA,Bisexuals,GLBT Persons,Gender Minorities,Homosexuals,LBG Persons,LGBT Persons,LGBTQ Persons,Lesbians,Lesbigay Persons,Men Who Have Sex With Men,Non-Heterosexual Persons,Non-Heterosexuals,Queers,Sexual Dissidents,Sexual Minorities,Women Who Have Sex With Women,Bisexual,Dissident, Sexual,Dissidents, Sexual,Diverse, Gender,GLBT Person,Gay,Gender Minority,Homosexual,LBG Person,LGBT Person,LGBTQ Person,Lesbian,Lesbigay Person,Minorities, Gender,Minorities, Sexual,Minority, Gender,Minority, Sexual,Non Heterosexual Persons,Non Heterosexuals,Non-Heterosexual,Non-Heterosexual Person,Person, GLBT,Person, LBG,Person, LGBT,Person, LGBTQ,Person, Lesbigay,Person, Non-Heterosexual,Persons, GLBT,Persons, LBG,Persons, LGBT,Persons, LGBTQ,Persons, Lesbigay,Queer,Sexual Dissident,Sexual Minority
D000076603 Syndemic Synergistically-interacting health conditions producing excess disease occurrence in a population. Syndemics
D000094422 Secondary Data Analysis Analysis or reanalysis of existing data collected by someone else usually for a different purpose. Analysis, Secondary Data,Data Analysis, Secondary,Secondary Data Analyses
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012309 Risk-Taking Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. Risk Behavior,Behavior, Risk,Behaviors, Risk,Risk Behaviors,Risk Taking
D012725 Sexual Behavior Sexual activities of humans. Anal Sex,Oral Sex,Sexual Activity,Sexual Orientation,Premarital Sex Behavior,Sex Behavior,Sex Orientation,Sexual Activities,Activities, Sexual,Activity, Sexual,Behavior, Premarital Sex,Behavior, Sex,Behavior, Sexual,Orientation, Sexual,Sex, Anal,Sex, Oral

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