A dose of drugs, a touch of violence, a case of AIDS, Part 2: Further conceptualizing the Sava Syndemic

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Merrill Singer


This paper builds on prior discussion of the concept of syndemics in the social science and public health literatures to further define and extend the utility of this construct in analyzing the relationships among substance abuse, violence and HIV/AIDS. The term syndemic refers to a set of closely entwined and mutual enhancing health problems that "working together" in a context of noxious social and physical conditions can significantly affect the overall disease burden and health status of a population. The paper focuses on the emergence of what is termed the SAVA (substance abuse, violence, AIDS) syndemic among several populations that are at high risk because they are subject to social discrimination, stigmatization, and subordination, namely abused children and battered women, men who have sex with men, illicit drug users, and commercial sex workers

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