Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action
dc.contributor.author | Peprah, E. | |
dc.contributor.author | Myers-Franchi, Bronwyn | |
dc.contributor.author | Kengne, A.P. | |
dc.contributor.author | Peer, N. | |
dc.contributor.author | El-Shahawy, O. | |
dc.contributor.author | Ojo, T. | |
dc.contributor.author | Mukasa, B. | |
dc.contributor.author | Ezechi, O. | |
dc.contributor.author | Iwelunmor, J. | |
dc.contributor.author | Ryan, N. | |
dc.contributor.author | Sakho, F. | |
dc.contributor.author | Patena, J. | |
dc.contributor.author | Gyamfi, J. | |
dc.date.accessioned | 2022-07-19T02:11:00Z | |
dc.date.available | 2022-07-19T02:11:00Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | Peprah, E. and Myers, B. and Kengne, A.P. and Peer, N. and El-Shahawy, O. and Ojo, T. and Mukasa, B. et al. 2022. Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action. International Journal of Environmental Research and Public Health. 19 (3): ARTN 1097. | |
dc.identifier.uri | http://hdl.handle.net/20.500.11937/88960 | |
dc.identifier.doi | 10.3390/ijerph19031097 | |
dc.description.abstract |
Substance use is increasing throughout Africa, with the prevalence of alcohol, tobacco, cannabis, and other substance use varying regionally. Concurrently, sub-Saharan Africa bears the world’s largest HIV burden, with 71% of people living with HIV (PWH) living in Africa. Problematic alcohol, tobacco, and other substance use among PWH is associated with multiple vulnerabilities comprising complex behavioral, physiological, and psychological pathways that include high-risk behaviors (e.g., sexual risk-taking), HIV disease progression, and mental health problems, all of which contribute to nonadherence to antiretroviral therapy. Physiologically, severe substance use disorders are associated with increased levels of biological markers of inflammation; these, in turn, are linked to increased mortality among PWH. The biological mechanisms that underlie the increased risk of substance use among PWH remain unclear. Moreover, the biobehavioral mechanisms by which substance use contributes to adverse health outcomes are understudied in low-and middle-income countries (LMIC). Syndemic approaches to understanding the co-occurrence of substance use and HIV have largely been limited to high-income countries. We propose a syndemic coupling conceptual model to disentangle substance use from vulnerabilities to elucidate underlying disease risk for PWH. This interventionist perspective enables assessment of biobehavioral mechanisms and identifies malleable targets of intervention. | |
dc.language | English | |
dc.publisher | MDPI | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Science & Technology | |
dc.subject | Life Sciences & Biomedicine | |
dc.subject | Environmental Sciences | |
dc.subject | Public, Environmental & Occupational Health | |
dc.subject | Environmental Sciences & Ecology | |
dc.subject | substance use | |
dc.subject | people living with HIV (PWH) | |
dc.subject | Africa | |
dc.subject | syndemics | |
dc.subject | SOUTH-AFRICA | |
dc.subject | ABUSE TREATMENT | |
dc.subject | USE DISORDERS | |
dc.subject | ALCOHOL-USE | |
dc.subject | CAPE-TOWN | |
dc.subject | USE DRUGS | |
dc.subject | HEALTH | |
dc.subject | STRESS | |
dc.subject | INFLAMMATION | |
dc.subject | MECHANISMS | |
dc.title | Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action | |
dc.type | Journal Article | |
dcterms.source.volume | 19 | |
dcterms.source.number | 3 | |
dcterms.source.issn | 1661-7827 | |
dcterms.source.title | International Journal of Environmental Research and Public Health | |
dc.date.updated | 2022-07-19T02:10:58Z | |
curtin.department | EnAble Institute | |
curtin.accessStatus | Open access | |
curtin.faculty | Faculty of Health Sciences | |
curtin.identifier.article-number | ARTN 1097 | |
dcterms.source.eissn | 1660-4601 | |
curtin.contributor.scopusauthorid | Myers-Franchi, Bronwyn [7202684194] |