HIV-Infected Individuals with Mental Illness: A Case of Syndemics - Abstract
The concept of syndemic is described as a term that is critical to better understand the interaction between multiple co-morbidities within vulnerable individuals, specifically to explicate the epidemiology of HIV among persons with serious mental illness (SMI), SMI among persons with HIV, and finally HIV among persons with opportunistic infections. Incidence rates among each of these vulnerable populations are reviewed and multiple factors are considered to explain the reported rates. The authors suggest that the syndemic may be driven by disparities in access to care, quality of the care that is provided, treatment adherence, availability and adequacy of housing, quality of social networks, as well as individual differences in risk behavior. Concluding remarks point to the importance of substance abuse as a mediator. The authors propose that future research efforts focus on interventions designed to address the HIV/SMI syndemic