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Social Justice

The Impact of Trauma, Depression and Substance Use on Black Sexual Minority Men and Transgender Womens Health in the US

Two studies on the role of syndemics

July 21, 2020

Associate Professor Typhanye Dyer and Assistant Research Professor Rodman Turpin conducted two studies on the role of syndemics—combinations of adverse social, structural and individual factors—on health outcomes among Black sexual minority men and transgender women in the US.

Dr. Dyer and Dr. Turpin are both a part of the Department of Epidemiology and Biostatistics and serve as investigators with the University of Maryland Prevention Research Center (UMD-PRC).

Both studies use data from the HIV Prevention Trials Network Study (HPTN) 061: The Brothers Study, a large prospective cohort of Black sexual minority men and transgender women in the US focused on developing interventions to prevent the transmission of HIV.

The study, Syndemic Latent Transition Analysis in the HPTN 061 Cohort: Prospective Interactions Between Trauma, Mental Health, Social Support, and Substance Use, demonstrates the importance of social support in the mental and behavioral health of the population. Syndemics characterized by depression and trauma were associated with greater polysubstance use, but social support protected against this relationship.

The study, Latent Profile Analysis of a Syndemic of Vulnerability Factors on Incident STI in a Cohort of Black Men Who Have Sex With Men Only (BMSMO) and Black Men Who Have Sex with Men and Women (BMSMW) in the HPTN061 Study, found that syndemics characterized by incarceration, depression, binge drinking and partner violence were associated with higher sexual risk.

"Both studies highlight how depression and related factors (e.g., trauma, binge drinking) are associated with adverse health outcomes among Black sexual minorities," the researchers said.

The studies' findings illustrate the value of mental and behavioral health to sexual minority populations, underscoring the importance of access to competent mental healthcare for sexual minorities.

This connection to mental health and health care reflects the UMD-PRC's commitment to research, service and training around issues of mental health among LGBTQ+ communities.

Dyer and Turpin are interested in how to best serve Black sexual minority men's health needs through understanding syndemics. Turpin, who also serves as an HPTN early-career investigator fellow along with co-author Dr. Derek Dangerfield II, credits his ongoing collaborations with his mentors in the Department of Epidemiology and Biostatistics, including Dr. Dyer and Dr. Hongjie Liu, with the development and support of much of his research on sexual minorities.

"We have also collaborated on additional HPTN papers related to similar aims, including a recent study focused on incarceration and substance use escalation led by Jonathan Feelemyer, also a member of Maria Khan's HPTN research team. We are looking forward to continuing this work with HPTN data," said Dr. Turpin.

The studies were collaborations between the University of Maryland Department of Epidemiology and Biostatistics, the UMD-PRC, New York University School of Medicine, Johns Hopkins University School of Nursing and the HPTN.