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(2008) proposed that syndemic health disparities among gay men are socially produced through two overarching dynamics: marginalization associated with early male adolescent socialization in heterosexist environments and the stressors associated with migration to large cities with sizeable gay communities. Theorizing that cultural marginalization alone may cause epidemics, Singer (1994) first used the term syndemic to explain low health profiles of substance-using Puerto Ricans in the urban Northeastern United States. There is ample evidence of the interconnection of these issues among samples of adult gay and bisexual men during the HIV/AIDS epidemic ( Colfax et al., 2004 Ostrow et al., 1993 Stall et al., 2001 Stall & Purcell, 2000 Valdiserri et al., 1988), and recent research among young MSM has revealed preliminary evidence as well ( Mustanski, Garofalo, Herrick, & Donenberg, 2007 Rusch, Lampinen, Schilder, & Hogg, 2004).
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It is posited that each of these epidemics mutually reinforce one another through intersections of high-risk behavior and function together to lower the health profile of gay men.
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A theory of “syndemic production” of health disparities among gay men in the urban United States has been proposed, linking high rates of depression, substance use, and HIV/AIDS as intertwined epidemics among groups of gay men that arise from negative childhood or adolescent experiences associated with their emergent gay identities ( Stall, Friedman, & Catania, 2008). In the United States, men who have sex with men (MSM) are affected by marked health disparities, including elevated prevalence rates of drug use ( Stall et al., 2001), HIV infection ( Centers for Disease Control and Prevention, 2008), and depression ( Mills et al., 2004).