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Research Blog > Syndemic Approach to HIV and Environmental Change

Posted on February 28th, 2013 by Greg in Featured, Research Blog. No Comments

Desert sand dunesA syndemic is a synergistic relationship between two conditions where the worsening of one, in turn, contributes to the worsening of the other and vice versa. Often times this will refer to multiple health risks that each enhances the negative outcomes of the other. Researchers Talman, Bolton, and Walson suggest a syndemic framework for the HIV/AIDs epidemic and environmental degradation [1]. Briefly, let’s look at one of their examples of how these two phenomena may be syndemic in nature and why this framework should be applied to HIV research.

Synergy between Environmental Change and HIV Risk

The authors, using mostly qualitative data from sub-Saharan African countries, give the example of climate change as a global factor. For example, long periods of drought can lead to decreases in availability of food, which may in turn lead to behavioral changes that could put people in increased risk for HIV, such as trading sex for food. These risky behaviors can then decrease a person’s ability to participate equally in the work force by compromising their health, especially in countries where the resources available to an HIV positive individual are less plentiful. Their compromised health can reduce their ability to work or farm, which can increase their dependence on natural resources, which may further degrade the land and impact the community’s resources. In this example, the situation can continue to spiral such that greater damage to the environment leads to greater HIV risk and HIV risk further damages the environment. This example represents a simplified version of a syndemic model, which may be specific to already impoverished countries, and illustrates the potential impact of global factors on HIV. The question then becomes, what are the benefits of applying this model?

Why Use the Syndemic Framework

Talmon, Bolton, and Walson argue that the current focus on behavioral change in HIV research is ultimately too narrow and ignores more global and macro factors (e.g., climate change, urbanization, globalization, war, etc.). They argue that the syndemic framework can address this limitation and would encourage interdisciplinary approaches that account for the bidirectional nature of environmental forces and HIV risk. At the same time, they acknowledge that different disciplines may approach these issues with dissimilar, and sometimes conflicting, priorities. Regardless of the challenges, however, the authors have identified a research gap that may be important as investigators grapple with global environmental change and the HIV/AIDs epidemic.



1. Talman, A., Bolton, S., & Walson, J. L. (2013) Interactions Between HIV/AIDS and the Environment: Toward a Syndemic Framework. American Journal of Public Health, 103(2), 253-261.

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