{"doi":"10.3390/ijerph22071065","title":"COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South","abstract":"<jats:p>Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness.</jats:p>","journal":"International Journal of Environmental Research and Public Health","year":2025,"id":652672,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1702659,"name":"Hannah E. Reynolds","orcid":null,"position":1,"is_corresponding":false},{"id":950228,"name":"Chadwick K. Campbell","orcid":"0000-0002-8609-5762","position":2,"is_corresponding":false},{"id":1302368,"name":"Kirstin Kielhold","orcid":"0009-0000-7175-1854","position":3,"is_corresponding":false},{"id":1133395,"name":"Wilson Vincent","orcid":"0000-0003-1995-4958","position":4,"is_corresponding":false},{"id":1702660,"name":"Daniel E. Siconolfi","orcid":null,"position":5,"is_corresponding":false},{"id":828514,"name":"Susan M. Kegeles","orcid":"0000-0003-4602-2275","position":6,"is_corresponding":false},{"id":861582,"name":"Erik D. Storholm","orcid":"0000-0001-7072-4248","position":7,"is_corresponding":false},{"id":364344,"name":"Carrie L. Nacht","orcid":"0000-0002-2533-3034","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South","abstract":"<jats:p>Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness.</jats:p>","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40724134","pmcid":"PMC12294665","openalex_id":"https://openalex.org/W4411980215","authors":[],"funders":[{"funder_name":"National Institute on Drug Abuse","grant_id":"R21 DA053164","title":null},{"funder_name":"National Institute on Drug Abuse","grant_id":"R01 MH102171","title":null},{"funder_name":"National Institute on Drug Abuse","grant_id":"P30 AI036214-29","title":null},{"funder_name":"National Institute on Drug Abuse","grant_id":"T32 DA023356","title":null},{"funder_name":"NIDA NIH HHS","grant_id":"R21DA044073","title":null},{"funder_name":"NIAID NIH HHS","grant_id":"P30 AI036214","title":null},{"funder_name":"National Institutes of Health","grant_id":"5P30AI036214-11","title":"Center for AIDS Research"},{"funder_name":"National Institutes of Health","grant_id":"2T32DA023356-06","title":"Training Program in Substance Use, HIV and Related Infections"},{"funder_name":"National Institutes of Health","grant_id":"5R01MH096690-04","title":"Multilevel HIV Prevention Intervention for Young African American Men"},{"funder_name":"National Institutes of Health","grant_id":"5R21DA053164-02","title":"Investigating the Impact of Substance Use, Intimate Partner Violence, and COVID-19 on HIV Care Engagement among Young Black Sexual Minority Men with HIV in the US South"}],"total_grants":10,"fwci":0.7951,"citation_percentile":0.70933831,"influential_citations":0,"citation_trend":[{"year":2025,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/1660-4601/22/7/1065/pdf?version=1751545934","host_type":"journal"},{"url":"https://www.mdpi.com/1660-4601/22/7/1065/pdf?version=1751545934","host_type":"publisher"},{"url":"https://www.mdpi.com/1660-4601/22/7/1065/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/ijerph22071065","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40724134","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12294665","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12294665","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12294665?pdf=render","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.3390/ijerph22071065","host_type":""},{"url":"https://dx.doi.org/10.3390/ijerph22071065","host_type":""}],"fields_of_study":["HIV/AIDS Research and Interventions","Intimate Partner and Family Violence","LGBTQ Health, Identity, and Policy"],"mesh_terms":["Intimate Partner Violence","Sexual and Gender Minorities","Syndemic","COVID-19","SARS-CoV-2","White","Adult","Black or African American","Humans","Longitudinal Studies","Male","Mental Health","Middle Aged","Texas","HIV Infections","Substance-Related Disorders"],"keywords":["Syndemic","Psychosocial","Domestic violence","Mental health","Medicine","Thematic analysis","Psychiatry","Psychological intervention","Substance abuse","Pandemic","Poison control","Suicide prevention","Qualitative research","Psychology","Environmental health","Gerontology","Public health","Coronavirus disease 2019 (COVID-19)","Nursing","Sociology","Hiv Care Engagement","Syndemics","Sexual Minority Men","Covid-19","Male","Adult","Substance-Related Disorders","SARS-CoV-2","Intimate Partner Violence","HIV Infections","White","Middle Aged","Texas","Article","Black or African American","Sexual and Gender Minorities","Humans","Longitudinal Studies"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T16:29:13.841814Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}