Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia.
Objetivo: Examinar el papel desempeñado por cuatro afecciones psicosociales: sexo forzado, iniciación sexual temprana, uso inadecuado de alcohol y drogas ilícitas en el riesgo de VIH e infecciones de transmisión sexual, en Cali-Colombia entre 2013-2015. Métodos: Utilizando datos de una campaña de consejería y pruebas de VIH en Cali, Colombia, probamos el efecto de la acumulación e interacciones de las cuatro condiciones psicosociales en la positividad al VIH y la positividad a otras enfermedades de transmisión sexual. Resultados: 604 participantes de las principales comunidades afectadas: hombres que tienen sexo con hombres, mujeres transgénero y trabajadoras sexuales. 733 participantes mujeres y hombres heterosexuales. Solo, abuso de droga... Ver más
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Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. SIDA Hacia la Promoción de la Salud Universidad de Caldas Núm. 2 , Año 2020 : Julio - Diciembre 2 25 sindémico infecciones de transmisión sexual Artículo de revista VIH Tello Bolívar, Inés Constanza Colombia Mueses Marín, Hector Fabio Alvarado Llano, Beatriz Eugenia Objetivo: Examinar el papel desempeñado por cuatro afecciones psicosociales: sexo forzado, iniciación sexual temprana, uso inadecuado de alcohol y drogas ilícitas en el riesgo de VIH e infecciones de transmisión sexual, en Cali-Colombia entre 2013-2015. Métodos: Utilizando datos de una campaña de consejería y pruebas de VIH en Cali, Colombia, probamos el efecto de la acumulación e interacciones de las cuatro condiciones psicosociales en la positividad al VIH y la positividad a otras enfermedades de transmisión sexual. Resultados: 604 participantes de las principales comunidades afectadas: hombres que tienen sexo con hombres, mujeres transgénero y trabajadoras sexuales. 733 participantes mujeres y hombres heterosexuales. Solo, abuso de drogas se asoció con positividad VIH (Razón de prevalencia = 2.3, IC 95%: 1.3–4.1), mientras que, todas las condiciones psicosociales se asociaron con historia de infecciones de transmisión sexual. La acumulación de condiciones sindémicas se relacionó con mayor probabilidad de historia de infecciones de transmisión sexual. Ninguna interacción probada fue significativa. Conclusiones: Nuestros hallazgos resaltan la importancia de intervenciones integrales de salud mental para abordar la epidemia de VIH en Colombia. Martínez Cajas, Jorge Luis Galindo Quintero, Jaime Reisen CA, Zea MC, Bianchi FT, Poppen PJ, del Rio Gonzalez AM, Romero RA, et al. HIV testing among MSM in Bogota, Colombia: the role of structural and individual characteristics. AIDS Educ Prev. 2014;26(4):328-44. Epub 2014/07/30. Mimiaga MJ, Biello KB, Robertson AM, Oldenburg CE, Rosenberger JG, O’Cleirigh C, et al. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America. Arch sex behav. 2015;44(7):1869-78. Epub 2015/07/15. Mustanski B, Phillips G, 2nd, Ryan DT, Swann G, Kuhns L, Garofalo R. Prospective Effects of a Syndemic on HIV and STI Incidence and Risk Behaviors in a Cohort of Young Men Who Have Sex with Men. AIDS behav 2017;21(3):845-57. Epub 2016/11/16. Mimiaga MJ, Noonan E, Donnell D, Safren SA, Koenen KC, Gortmaker S, et al. Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE Study. J Acquir Immune Defic Syndr. 2009;51(3):340-8. Epub 2009/04/16. Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36(1):38-56. Epub 1995/03/01. Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People. J Acquir Immune Defic Syndr. 2016;72 Suppl 3:S210-9. Epub 2016/07/20. VanderWeele TJ. Explanation in causal inference: developments in mediation and interaction. Int J epidemiol. 2016;45(6):1904-8. Epub 2016/11/20. Míguez-Burbano MJ, Page JB, Angarita I, Rodríguez N, Baum MK, Burbano X, et al. High-risk behaviours in men from Bogota, Colombia and the spread of HIV. Int J STD AIDS. 2001;12(11):739- 43. Epub 2001/10/09. Arrivillaga M, Hoyos PA, Tovar LM, Varela MT, Correa D, Zapata H. HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services. Int J STD AIDS. 2012;23(11):815-21. Epub 2012/11/17. Míguez-Burbano MJ, Angarita I, Shultz JM, Shor-Posner G, Klaskala W, Duque JL, et al. HIVrelated high risk sexual behaviors and practices among women in Bogota, Colombia. Women Health. 2000;30(4):109-19. Epub 2000/09/13. Tsai AC, Venkataramani AS. Syndemics and Health Disparities: A Methodological Note. AIDS Behav. 2016;20(2):423-30. Epub 2015/12/15. Santos GM, Do T, Beck J, Makofane K, Arreola S, Pyun T, et al. Syndemic conditions associated with increased HIV risk in a global sample of men who have sex with men. Sex Transm Infect. 2014;90(3):250-3. Epub 2014/01/17. ICBF.Concepto general unificado niñez y adolescencia. 2010 [2018]; Retrieved from: http://www.icbf.gov.co/cargues/avance/docs/concepto_icbf_0027891_2010.htm. FHI. Behavioral surveillance surveys (BSS) guidelines for repeated behavioral surveys in populations at risk of HIV. Arlington, VA: Family Health International 2000. Galindo-Quintero J, Mueses-Marin HF, Montano-Agudelo D, Pinzón-Fernández MV, Tello-Bolívar IC, Alvarado-Llano BE, et al. HIV Testing and Counselling in Colombia: Local Experience on Two Different Recruitment Strategies to Better Reach Low Socioeconomic Status Communities. AIDS Res Treat. 2014;2014:803685. Epub 2014/03/05. Departamento Administrativo de Planeación. Cali en cifras. 2017 [2018]; Retrieved from: http://www.cali.gov.co/planeacion/publicaciones/137801/libro-cali-en-cifras-inicio/. Bobadilla ML, Zorrilla ME, Mancuello A, Goldman M, Prieto F, López G, et al. Evaluación de diez pruebas rápidas para el diagnóstico del virus de la inmunodeficiencia humana/Evaluation of ten rapid tests for the diagnosis of human immunodeficiency virus. Revista Paraguaya de Epidemiología. 2014;2(2):5-12. Cáceres CF, Konda KA, Salazar X, Leon SR, Klausner JD, Lescano AG, et al. New populations at high risk of HIV/STIs in low-income, urban coastal Peru. AIDS Behav. 2008;12(4):544-51. Epub 2007/12/28. Parsons JT, Antebi-Gruszka N, Millar BM, Cain D, Gurung S. Syndemic Conditions, HIV Transmission Risk Behavior, and Transactional Sex Among Transgender Women. AIDS Behav. 2018;22(7):2056-67. Epub 2018/03/29. http://purl.org/coar/resource_type/c_6501 http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/publishedVersion http://purl.org/redcol/resource_type/ART http://purl.org/coar/resource_type/c_2df8fbb1 info:eu-repo/semantics/article Text Prachniak-Rincón C, Villar de Onís J. HIV and the Right to Health in Colombia. Health Hum Rights. 2016;18(2):157-69. Epub 2017/06/01. Rodríguez Hernández JM, Rodríguez Rubiano DP, Corrales Barona JC. Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013. Ciênc. saúde coletiva. 2015;20(6):1947-58. Mueses HF, Pinzón MV, Tello IC, Rincón-Hoyos HG, Galindo J. HIV and risk behaviors of persons of low socio-economic status, Popayan-Colombia (2008-2009). Colomb Med (Cali). 2013;44(1):7-12. Epub 2013/01/01. UNFPA. Comportamiento sexual y prevalencia de VIH en mujeres trabajadores sexuales en 4 ciudades de Colombia. Bogotá: 2009 [2018]; Retrieved from: https://colombia.unfpa.org/sites/default/files/pub-pdf/CorportamiTSweb.pdf Semple SJ, Strathdee SA, Pitpitan EV, Chavarin C, Patterson TL. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico. Arch Sex Behav. 2015;44(4):1025-33. Epub 2015/03/22. González-Guarda RM, Florom-Smith AL, Thomas T. A syndemic model of substance abuse, intimate partner violence, HIV infection, and mental health among Hispanics. Public Health Nurs. 2011;28(4):366-78. Epub 2011/07/09. Pitpitan EV, Kalichman SC, Eaton LA, Cain D, Sikkema KJ, Watt MH, et al. Co-occurring psychosocial problems and HIV risk among women attending drinking venues in a South African township: a syndemic approach. Ann Behav Med. 2013;45(2):153-62. Epub 2012/10/12. Míguez-Burbano MJ, de Pool I, Hadrigan S, Jackson J, Jr., Angarita I, Then EP, et al. HIV knowledge and risk behaviors among women in law enforcement in Bogota, Colombia: potential role as community educators. J Urban Health. 2005;82(3 Suppl 4):iv43-57. Epub 2005/08/19. Mimiaga MJ, O’Cleirigh C, Biello KB, Robertson AM, Safren SA, Coates TJ, et al. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J Acquir Immune Defic Syndr. 2015;68(3):329-36. Epub 2014/12/17. Proyecto VIH Fondo Mundial. Resultados del estudio comportamiento sexual y prevalencia de la infección por VIH en mujeres trans en cuatro ciudades de Colombia, 2012. Colombia: Fondo Mundial de lucha contra el Sida, la Tuberculosis y Malaria; 2013.124 p. https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2366 Objective: We examined the role played by four psychosocial conditions: forced sex, early sexual initiation, and misuse of alcohol and illicit drugs on the risk of HIV and sexually transmitted infections in Cali-Colombia between 2013 and 2015. Methods: Using data from an HIV counseling and testing campaign in Cali, Colombia, we tested the effect of the accumulation and interactions of the four psychosocial conditions on both outcomes. Results: A total of 604 participants were representative subjects from key affected communities: men who have sex with men, transgender women and female sex workers. A total of 733 participants were heterosexual women and men. Only drug abuse was associated with HIV positivity (Prevalence ratio=2.3, CI 95%: 1.3–4.1), while all psychosocial conditions were associated with sexually transmitted infection history. The accumulation of the syndemic conditions was related to a higher likelihood of sexually transmitted infection history. None of the interactions tested was significant. Conclusions: Our findings highlight the importance of comprehensive mental health interventions in addressing HIV epidemics in Colombia. Colombia HIV AIDS sexually transmitted infections syndemics VIH AIDS infeções de transmissão sexual sindémico (palavra que reúne o social e o biológico) Colômbia Journal article application/pdf Proyecto VIH Fondo Mundial. Resultados del estudio comportamiento sexual y prevalencia de la infección por VIH en mujeres trabajadoras sexuales en cinco ciudades de Colombia,2012: Mecanismo de coordinación de País-MCP Colombia Fondo Mundial de lucha contra el Sida, la Tuberculosis y Malaria; 2013. Publication Singer MC, Erickson PI, Badiane L, Diaz R, Ortiz D, Abraham T, et al. Syndemics, sex and the city: understanding sexually transmitted diseases in social and cultural context. Soc Sci Med. 2006;63(8):2010-21. Epub 2006/06/20. Rubio Mendoza ML, Jacobson JO, Morales-Miranda S, Sierra Alarcon CA, Luque Núñez R. High HIV Burden in Men Who Have Sex with Men across Colombia’s Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study. PLoS One. 2015;10(8):e0131040. Epub 2015/08/08. Inglés Zea MC, Reisen CA, del Rio-González AM, Bianchi FT, Ramirez-Valles J, Poppen PJ. HIV Prevalence and Awareness of Positive Serostatus Among Men Who Have Sex With Men and Transgender Women in Bogota, Colombia. Am J Public Health. 2015;105(8):1588-95. Epub 2015/01/21. Cáceres CF. HIV among gay and other men who have sex with men in Latin America and the Caribbean: a hidden epidemic? AIDS. 2002;16 Suppl 3:S23-33. Epub 2003/04/11. Chakrapani V, Lakshmi PVM, Tsai AC, Vijin PP, Kumar P, Srinivas V. The syndemic of violence victimisation, drug use, frequent alcohol use, and HIV transmission risk behaviour among men who have sex with men: Cross-sectional, population-based study in India. SSM popul health. 2019;7 https://creativecommons.org/licenses/by-nc-sa/4.0/ Tomori C, McFall AM, Solomon SS, Srikrishnan AK, Anand S, Balakrishnan P, et al. Is there synergy in syndemics? Psychosocial conditions and sexual risk among men who have sex with men in India. Soc Sci Med. 2018;206:110-6. Epub 2018/04/05. Muñoz-Laboy M, Martinez O, Levine EC, Mattera BT, Fernández MI. Syndemic Conditions Reinforcing Disparities in HIV and Other STIs in an Urban Sample of Behaviorally Bisexual Latino Men. J Immigr Minor health. 2018; 20 (2): p. 497-501. Epub 2017/03/28. Examining a syndemic framework for HIV and sexually transmitted infections Risk in Cali, Colombia. Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17(4): 423-41. Epub 2004/01/14. 10.17151/hpsal.2020.25.2.14 https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/download/2366/2272 2462-8425 153 140 2020-07-01T00:00:00Z 2020-07-01T00:00:00Z 2020-07-01 https://doi.org/10.17151/hpsal.2020.25.2.14 0121-7577 |
| institution |
UNIVERSIDAD DE CALDAS |
| thumbnail |
https://nuevo.metarevistas.org/UNIVERSIDADDECALDAS/logo.png |
| country_str |
Colombia |
| collection |
Hacia la Promoción de la Salud |
| title |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. |
| spellingShingle |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. Tello Bolívar, Inés Constanza Mueses Marín, Hector Fabio Alvarado Llano, Beatriz Eugenia Martínez Cajas, Jorge Luis Galindo Quintero, Jaime SIDA sindémico infecciones de transmisión sexual Colombia Colombia AIDS sexually transmitted infections syndemics AIDS infeções de transmissão sexual sindémico (palavra que reúne o social e o biológico) Colômbia |
| title_short |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. |
| title_full |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. |
| title_fullStr |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. |
| title_full_unstemmed |
Examinando un marco sindémico para el VIH y el riesgo de infecciones de transmisión sexual en Cali, Colombia. |
| title_sort |
examinando un marco sindémico para el vih y el riesgo de infecciones de transmisión sexual en cali, colombia. |
| title_eng |
Examining a syndemic framework for HIV and sexually transmitted infections Risk in Cali, Colombia. |
| description |
Objetivo: Examinar el papel desempeñado por cuatro afecciones psicosociales: sexo forzado, iniciación sexual temprana, uso inadecuado de alcohol y drogas ilícitas en el riesgo de VIH e infecciones de transmisión sexual, en Cali-Colombia entre 2013-2015. Métodos: Utilizando datos de una campaña de consejería y pruebas de VIH en Cali, Colombia, probamos el efecto de la acumulación e interacciones de las cuatro condiciones psicosociales en la positividad al VIH y la positividad a otras enfermedades de transmisión sexual. Resultados: 604 participantes de las principales comunidades afectadas: hombres que tienen sexo con hombres, mujeres transgénero y trabajadoras sexuales. 733 participantes mujeres y hombres heterosexuales. Solo, abuso de drogas se asoció con positividad VIH (Razón de prevalencia = 2.3, IC 95%: 1.3–4.1), mientras que, todas las condiciones psicosociales se asociaron con historia de infecciones de transmisión sexual. La acumulación de condiciones sindémicas se relacionó con mayor probabilidad de historia de infecciones de transmisión sexual. Ninguna interacción probada fue significativa. Conclusiones: Nuestros hallazgos resaltan la importancia de intervenciones integrales de salud mental para abordar la epidemia de VIH en Colombia.
|
| description_eng |
Objective: We examined the role played by four psychosocial conditions: forced sex, early sexual initiation, and misuse of alcohol and illicit drugs on the risk of HIV and sexually transmitted infections in Cali-Colombia between 2013 and 2015. Methods: Using data from an HIV counseling and testing campaign in Cali, Colombia, we tested the effect of the accumulation and interactions of the four psychosocial conditions on both outcomes. Results: A total of 604 participants were representative subjects from key affected communities: men who have sex with men, transgender women and female sex workers. A total of 733 participants were heterosexual women and men. Only drug abuse was associated with HIV positivity (Prevalence ratio=2.3, CI 95%: 1.3–4.1), while all psychosocial conditions were associated with sexually transmitted infection history. The accumulation of the syndemic conditions was related to a higher likelihood of sexually transmitted infection history. None of the interactions tested was significant. Conclusions: Our findings highlight the importance of comprehensive mental health interventions in addressing HIV epidemics in Colombia.
|
| author |
Tello Bolívar, Inés Constanza Mueses Marín, Hector Fabio Alvarado Llano, Beatriz Eugenia Martínez Cajas, Jorge Luis Galindo Quintero, Jaime |
| author_facet |
Tello Bolívar, Inés Constanza Mueses Marín, Hector Fabio Alvarado Llano, Beatriz Eugenia Martínez Cajas, Jorge Luis Galindo Quintero, Jaime |
| topicspa_str_mv |
SIDA sindémico infecciones de transmisión sexual Colombia |
| topic |
SIDA sindémico infecciones de transmisión sexual Colombia Colombia AIDS sexually transmitted infections syndemics AIDS infeções de transmissão sexual sindémico (palavra que reúne o social e o biológico) Colômbia |
| topic_facet |
SIDA sindémico infecciones de transmisión sexual Colombia Colombia AIDS sexually transmitted infections syndemics AIDS infeções de transmissão sexual sindémico (palavra que reúne o social e o biológico) Colômbia |
| citationvolume |
25 |
| citationissue |
2 |
| citationedition |
Núm. 2 , Año 2020 : Julio - Diciembre |
| publisher |
Universidad de Caldas |
| ispartofjournal |
Hacia la Promoción de la Salud |
| source |
https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2366 |
| language |
Inglés |
| format |
Article |
| rights |
http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/4.0/ |
| references_eng |
Reisen CA, Zea MC, Bianchi FT, Poppen PJ, del Rio Gonzalez AM, Romero RA, et al. HIV testing among MSM in Bogota, Colombia: the role of structural and individual characteristics. AIDS Educ Prev. 2014;26(4):328-44. Epub 2014/07/30. Mimiaga MJ, Biello KB, Robertson AM, Oldenburg CE, Rosenberger JG, O’Cleirigh C, et al. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America. Arch sex behav. 2015;44(7):1869-78. Epub 2015/07/15. Mustanski B, Phillips G, 2nd, Ryan DT, Swann G, Kuhns L, Garofalo R. Prospective Effects of a Syndemic on HIV and STI Incidence and Risk Behaviors in a Cohort of Young Men Who Have Sex with Men. AIDS behav 2017;21(3):845-57. Epub 2016/11/16. Mimiaga MJ, Noonan E, Donnell D, Safren SA, Koenen KC, Gortmaker S, et al. Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE Study. J Acquir Immune Defic Syndr. 2009;51(3):340-8. Epub 2009/04/16. Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36(1):38-56. Epub 1995/03/01. Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People. J Acquir Immune Defic Syndr. 2016;72 Suppl 3:S210-9. Epub 2016/07/20. VanderWeele TJ. Explanation in causal inference: developments in mediation and interaction. Int J epidemiol. 2016;45(6):1904-8. Epub 2016/11/20. Míguez-Burbano MJ, Page JB, Angarita I, Rodríguez N, Baum MK, Burbano X, et al. High-risk behaviours in men from Bogota, Colombia and the spread of HIV. Int J STD AIDS. 2001;12(11):739- 43. Epub 2001/10/09. Arrivillaga M, Hoyos PA, Tovar LM, Varela MT, Correa D, Zapata H. HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services. Int J STD AIDS. 2012;23(11):815-21. Epub 2012/11/17. Míguez-Burbano MJ, Angarita I, Shultz JM, Shor-Posner G, Klaskala W, Duque JL, et al. HIVrelated high risk sexual behaviors and practices among women in Bogota, Colombia. Women Health. 2000;30(4):109-19. Epub 2000/09/13. Tsai AC, Venkataramani AS. Syndemics and Health Disparities: A Methodological Note. AIDS Behav. 2016;20(2):423-30. Epub 2015/12/15. Santos GM, Do T, Beck J, Makofane K, Arreola S, Pyun T, et al. Syndemic conditions associated with increased HIV risk in a global sample of men who have sex with men. Sex Transm Infect. 2014;90(3):250-3. Epub 2014/01/17. ICBF.Concepto general unificado niñez y adolescencia. 2010 [2018]; Retrieved from: http://www.icbf.gov.co/cargues/avance/docs/concepto_icbf_0027891_2010.htm. FHI. Behavioral surveillance surveys (BSS) guidelines for repeated behavioral surveys in populations at risk of HIV. Arlington, VA: Family Health International 2000. Galindo-Quintero J, Mueses-Marin HF, Montano-Agudelo D, Pinzón-Fernández MV, Tello-Bolívar IC, Alvarado-Llano BE, et al. HIV Testing and Counselling in Colombia: Local Experience on Two Different Recruitment Strategies to Better Reach Low Socioeconomic Status Communities. AIDS Res Treat. 2014;2014:803685. Epub 2014/03/05. Departamento Administrativo de Planeación. Cali en cifras. 2017 [2018]; Retrieved from: http://www.cali.gov.co/planeacion/publicaciones/137801/libro-cali-en-cifras-inicio/. Bobadilla ML, Zorrilla ME, Mancuello A, Goldman M, Prieto F, López G, et al. Evaluación de diez pruebas rápidas para el diagnóstico del virus de la inmunodeficiencia humana/Evaluation of ten rapid tests for the diagnosis of human immunodeficiency virus. Revista Paraguaya de Epidemiología. 2014;2(2):5-12. Cáceres CF, Konda KA, Salazar X, Leon SR, Klausner JD, Lescano AG, et al. New populations at high risk of HIV/STIs in low-income, urban coastal Peru. AIDS Behav. 2008;12(4):544-51. Epub 2007/12/28. Parsons JT, Antebi-Gruszka N, Millar BM, Cain D, Gurung S. Syndemic Conditions, HIV Transmission Risk Behavior, and Transactional Sex Among Transgender Women. AIDS Behav. 2018;22(7):2056-67. Epub 2018/03/29. Prachniak-Rincón C, Villar de Onís J. HIV and the Right to Health in Colombia. Health Hum Rights. 2016;18(2):157-69. Epub 2017/06/01. Rodríguez Hernández JM, Rodríguez Rubiano DP, Corrales Barona JC. Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013. Ciênc. saúde coletiva. 2015;20(6):1947-58. Mueses HF, Pinzón MV, Tello IC, Rincón-Hoyos HG, Galindo J. HIV and risk behaviors of persons of low socio-economic status, Popayan-Colombia (2008-2009). Colomb Med (Cali). 2013;44(1):7-12. Epub 2013/01/01. UNFPA. Comportamiento sexual y prevalencia de VIH en mujeres trabajadores sexuales en 4 ciudades de Colombia. Bogotá: 2009 [2018]; Retrieved from: https://colombia.unfpa.org/sites/default/files/pub-pdf/CorportamiTSweb.pdf Semple SJ, Strathdee SA, Pitpitan EV, Chavarin C, Patterson TL. Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico. Arch Sex Behav. 2015;44(4):1025-33. Epub 2015/03/22. González-Guarda RM, Florom-Smith AL, Thomas T. A syndemic model of substance abuse, intimate partner violence, HIV infection, and mental health among Hispanics. Public Health Nurs. 2011;28(4):366-78. Epub 2011/07/09. Pitpitan EV, Kalichman SC, Eaton LA, Cain D, Sikkema KJ, Watt MH, et al. Co-occurring psychosocial problems and HIV risk among women attending drinking venues in a South African township: a syndemic approach. Ann Behav Med. 2013;45(2):153-62. Epub 2012/10/12. Míguez-Burbano MJ, de Pool I, Hadrigan S, Jackson J, Jr., Angarita I, Then EP, et al. HIV knowledge and risk behaviors among women in law enforcement in Bogota, Colombia: potential role as community educators. J Urban Health. 2005;82(3 Suppl 4):iv43-57. Epub 2005/08/19. Mimiaga MJ, O’Cleirigh C, Biello KB, Robertson AM, Safren SA, Coates TJ, et al. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J Acquir Immune Defic Syndr. 2015;68(3):329-36. Epub 2014/12/17. Proyecto VIH Fondo Mundial. Resultados del estudio comportamiento sexual y prevalencia de la infección por VIH en mujeres trans en cuatro ciudades de Colombia, 2012. Colombia: Fondo Mundial de lucha contra el Sida, la Tuberculosis y Malaria; 2013.124 p. Proyecto VIH Fondo Mundial. 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