The interplay of syndemic production and serosorting in drug-using gay and bisexual men

The relationships between mental health, substance use, and sexual behaviors among gay and bisexual men in a sample of 450 club drug-using men from New York City were examined using syndemics theory. Risk scores for each participant were based on variables measuring substance use and mental health burden. Participants with higher risk scores were significantly more likely to engage in risk behaviors. Risk taking was also explained by serosorting, suggesting that syndemics theory in and of itself, while significant in explaining risk, is not sufficient. These findings suggest we need to understand the interplay between social, emotional, and cognitive factors to understand sexual risk taking.